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Corneal ulceration in Tanzanian children: relationship between measles and vitamin A deficiency
Insights
Vitamin A deficiency caused 16.4% of childhood corneal ulcers in Tanzania. A significant decrease was observed between 1982-1984 and 1986-1988, potentially due to improved measles vaccination rates.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Corneal ulceration in children is a significant cause of visual impairment.
- Vitamin A deficiency is a known risk factor for xerophthalmia and subsequent corneal damage.
- Prospective studies are crucial for understanding disease trends and intervention impacts.
Purpose of the Study:
- To assess the prevalence of vitamin A deficiency as a cause of corneal ulceration in Tanzanian children.
- To identify trends in vitamin A deficiency-related corneal ulcers over two distinct periods.
- To explore potential factors contributing to observed changes in prevalence.
Main Methods:
- Prospective cohort studies conducted in Tanzania over two 3-year periods (1982-1984 and 1986-1988).
- Identification and clinical assessment of 189 children diagnosed with corneal ulceration.
- Statistical analysis to compare the proportion of ulcers attributed to vitamin A deficiency between the two study periods.
Main Results:
- Vitamin A deficiency accounted for 16.4% (31 of 189) of all corneal ulcers studied.
- The proportion of corneal ulcers due to vitamin A deficiency decreased significantly from 23.4% (25/107) in 1982-1984 to 7.3% (6/82) in 1986-1988 (P = 0.006).
- A notable decline in vitamin A deficiency-related corneal ulcers was observed in the later study period.
Conclusions:
- Vitamin A deficiency remains a relevant cause of corneal ulceration in children in Tanzania.
- The observed decrease in deficiency-related ulcers suggests a positive public health impact, possibly linked to enhanced measles immunization coverage.
- Continued monitoring and interventions targeting vitamin A deficiency and childhood infections are warranted.
Abstract:
Two 3-year prospective studies from 1982-1984 and 1986-1988 in Tanzania identified 189 children with corneal ulceration, of whom 31 (16.4%) were due to vitamin A deficiency. In 1982-1984, vitamin A deficiency was responsible for 23.4% of corneal ulcers (25 of 107) compared with 7.3% (6 of 82) from 1986-1988 (P = 0.006). It is postulated that the decrease in corneal ulceration due to vitamin A deficiency can be attributed to improved measles immunization coverage.