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A clinical and cytological study of vitamin A deficiency in Kiribati
Insights
Vitamin A deficiency in Kiribati children under seven showed significant clinical and histological abnormalities. The study highlights a higher prevalence in males and increasing risk with age.
Area of Science:
- Nutritional epidemiology
- Ophthalmology
- Public health
Background:
- Vitamin A deficiency is a significant global health concern, particularly in young children.
- Clinical signs of Vitamin A deficiency can be subtle and may not always correlate with histological findings.
- Conjunctival impression cytology offers a minimally invasive method for assessing Vitamin A status.
Purpose of the Study:
- To assess Vitamin A status in children under seven years in Kiribati using clinical examination and conjunctival impression cytology.
- To determine the correlation between clinical signs and histological findings of Vitamin A deficiency.
- To investigate the prevalence of Vitamin A deficiency based on sex and age.
Main Methods:
- A cross-sectional study involving 230 children under seven years in the Republic of Kiribati.
- Clinical assessment of Vitamin A deficiency signs.
- Conjunctival impression cytology for histological evaluation of ocular surface changes.
- Statistical analysis to determine correlations and prevalence.
Main Results:
- Of 185 children with readable histology, 14.6% showed both clinical and histological abnormalities.
- 19.5% were clinically abnormal but histologically normal, while 15.7% were clinically normal but histologically abnormal.
- A significant correlation (P < 0.001) was observed between clinical disease and histological findings.
- Prevalence was higher in males (45.8%) than females (26.3%), with risk increasing with age.
Conclusions:
- Clinical assessment alone may underestimate or overestimate Vitamin A deficiency.
- Conjunctival impression cytology is a valuable tool for accurate diagnosis of Vitamin A deficiency.
- Targeted interventions are needed, considering the higher prevalence in males and older children in Kiribati.
Abstract:
Vitamin A status was assessed clinically and by conjunctival impression cytology in a selected group under seven years of age in the Republic of Kiribati. A total of 230 children were studied. Of 185 with readable histology, 14.6% were clinically and histologically abnormal; 19.5% were clinically abnormal but histologically normal; and 15.7% were clinically normal and histologically abnormal. The remainder (50.3%) were clinically and histologically normal. There was a significant correlation between clinical disease and histology (P < 0.001). The prevalence of the disease in males was 45.8% and 26.3% in females. The risk of deficiency appeared to increase with advancing age. There was no significant difference between the two villages studied.