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Vitamin A deficiency in children with acute diarrhoea: a community-based study in Bangladesh
F U Ahmed1, M E Rahman, C B Mahmood
1Chittagong Medical College and Hospital, Bangladesh.
Insights
Nightblindness and xerophthalmia are prevalent in Bangladeshi children with diarrhea, indicating vitamin A deficiency. Early detection and nutrition education are crucial for prevention and treatment.
Area of Science:
- Ophthalmology
- Nutritional Science
- Pediatrics
Background:
- Vitamin A deficiency is a leading cause of preventable childhood blindness.
- Nightblindness and xerophthalmia are clinical signs of vitamin A deficiency.
- Acute diarrhea can exacerbate vitamin A deficiency in children.
Purpose of the Study:
- To assess the prevalence of nightblindness and xerophthalmia in children with acute diarrhea in rural Bangladesh.
- To identify risk factors associated with nightblindness in this population.
- To evaluate the impact of vitamin A supplementation on nightblindness prevalence.
Main Methods:
- A cross-sectional study was conducted on 400 children aged 6-59 months with acute diarrhea.
- Prevalence of nightblindness, conjunctival xerosis, and Bitot's spot were recorded.
- Logistic regression analysis was used to identify risk factors and model prediction.
Main Results:
- Prevalence rates were 7.8% for nightblindness, 9.5% for conjunctival xerosis, and 2.7% for Bitot's spot.
- Nightblindness was significantly associated with male sex, dysentery, undernutrition, inadequate vitamin A food intake, and lack of breastfeeding.
- Lower prevalence of nightblindness was observed with higher coverage of periodic vitamin A capsule administration.
Conclusions:
- Vitamin A deficiency, manifesting as nightblindness and xerophthalmia, is a significant concern in children with acute diarrhea in rural Bangladesh.
- Risk factors include male sex, dysentery, poor vitamin A intake, and lack of breastfeeding.
- Maternal education on recognizing nightblindness symptoms and seeking timely treatment, alongside accessible nutrition education and vitamin A supplementation programs, is recommended.
Abstract:
The prevalences of nightblindness and xerophthalmia were assessed in 400 children, aged 6-59 months, with acute diarrhoea in a rural community in Bangladesh. The prevalences of nightblindness, conjunctival xerosis, and Bitot's spot were 7.8%, 9.5%, and 2.7% respectively. Fifty-two percent of the children who complained of nightblindness had ocular signs of vitamin A deficiency compared to 9% of those without nightblindness (p < 0.000). The nightblindness was significantly higher among the male children, aged 24-59 months, who were dysenteric and undernourished, did not consume vitamin A-containing foods daily, and were not breastfed. The coverage of periodic administration of vitamin A capsule was inversely related to the prevalence of nightblindness. This finding was determined by logistic regression analysis of data indicating that a combination of male sex, history of dysentery, absence of periodic administration of vitamin A treatment, and daily intake of vitamin A-containing foods gave the best-fitted model with an overall prediction of 92.5% of being nightblind. The findings of the study suggest that mothers should be educated to observe their diarrhoeal children about development of nightblindness and to seek treatment for it. The locally-relevant nutrition education should also be offered to them.