Academic journal article Bulletin of the World Health Organization

Prevalence of Vitamin A Deficiency in Children Aged 6-9 Years in Wukro, Northern Ethiopia

Academic journal article Bulletin of the World Health Organization

Prevalence of Vitamin A Deficiency in Children Aged 6-9 Years in Wukro, Northern Ethiopia

Article excerpt

Objective To determine the prevalence of vitamin A deficiency in children aged 6-9 years in northern Ethiopia.

Methods A cross-sectional study was carried out and the data were analysed for 824 (61.5%) of 1339 eligible children for whom there was complete information on biochemical vitamin A status, dietary vitamin A intake, ocular examination for xerophthalmia, and anthropometry.

Findings The prevalence of xerophthalmia was 5.8%; serum retinol levels were below 0.35 [micro]mol/l and between 0.3 5 and 0.70 [micro]mol/l in 8.4% and 51.1% of the children respectively. The liver vitamin A reserve (modified relative dose response ratio [is greater than or equal to] 0.06) was low in 41.0% of the children.

Conclusion The high prevalence of severe vitamin A deficiency in children aged 6-9 years indicates the need to reevaluate the practice of targeting vitamin A supplementation programmes on children under 6 years of age in areas where vitamin A deficiency is endemic.

Keywords Vitamin A deficiency/epidemiology; Vitamin A/administration and dosage/blood; Xerophthalmia/ etiology; Child; Cross-sectional studies; Ethiopia (source: MeSH).

Mots cles Retinol, Carence/epidemiologie; Vitamine A/administration et posologie/sang; Xerophtalmie/etiologie; Enfant; Etude section efficace; Ethiopie (source: INSERM).

Palabras clave Deficiencia de vitamina A/epidemiologia; Vitamina A/administracion y dosificacion/sangre; Xeroftalmia/etiologia; Nino; Estudios transversales; Etiopia (fuente: BIREME).

Bulletin of the World Health Organization, 2001, 79: 415-422.

Voir page 421 le resume en francais. En la pagina 421 figura un resumen en espanol.

Introduction

Some 250 million preschool children are at risk of vitamin A deficiency, mainly in developing countries (1). The largest number of countries affected is in Africa, whereas the largest number of children with this deficiency is in south-east Asia (2) because of insufficiently varied diets, poor maternal education and inadequate hygiene (3, 4). In Ethiopia, vitamin A deficiency of public health significance was identified in 1958 (5, 6). Subsequent surveys revealed low dietary vitamin A intake except in the southern region (7-9). Specific evidence of vitamin A deficiency in children and pregnant and lactating women (10-15) underscored the gravity of the problem.

In 1989 the Ethiopian Nutrition Institute adopted a national intervention programme with the aim of reducing the prevalence of vitamin A deficiency to a level that would not be of significance from the public health standpoint by 2000. The programme involves screening vulnerable children and the treatment of xerophthalmic children by trained personnel. Capsules containing high doses of vitamin A are distributed in high-risk areas. Nutritional education and the development of horticulture are promoted (16). The distribution of high-dose vitamin A capsules through the Expanded Programme on Immunization began in 1996 (17).

In all of these interventions the targeted groups are usually infants, who receive capsules containing 100 000 IU vitamin A, and lactating mothers and children below 6 years of age, who are given 200 000 IU. In addition the Bureau of Health, supported by UNICEF, distributes capsules containing 50 000 IU vitamin A to pregnant mothers in the rural areas of Tigray (18). The targeting of vulnerable groups is necessary in countries where resources are limited. However, the evaluation of vitamin A deficiency in other segments of the population also deserves attention. Some studies on the magnitude of vitamin A deficiency have included schoolchildren with children under 6 years of age but the gravity of the problem has not been clearly established in older age groups. There is evidence from Ethiopia (12, 13, 19) and South Africa (20) that the prevalence of vitamin A deficiency in children increases with age. This contrasts with a World Bank report of zero prevalence of vitamin A deficiency in children aged 5-14 years in developing countries (21). …

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