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Published on: July 5, 2017
Vitamin A deficiency among Kenyan children as detected by conjunctival impression cytology
R M Munene1, H S Adala, M S Masinde
1Kenyatta National Hospital, PO Box 29871-KNH, Nairobi, Kenya.
Insights
Vitamin A deficiency (VAD) is a significant health issue in Kenyan children, with high rates of abnormal conjunctival cytology found in high-risk areas. This highlights the need for targeted interventions to prevent vision impairment.
Area of Science:
- Ophthalmology
- Public Health
- Nutritional Science
Background:
- Vitamin A deficiency (VAD) is a leading cause of preventable childhood blindness globally.
- Xerophthalmia, a severe manifestation of VAD, affects children in developing countries.
- Early detection and intervention are crucial to prevent irreversible vision loss.
Purpose of the Study:
- To determine the prevalence of Xerophthalmia among Kenyan children aged four to seven years in high-risk areas.
- To assess clinical and cytological features of VAD using Conjunctival Impression Cytology and Transfer (CICT).
Main Methods:
- A cross-sectional, community-based study was conducted in Mathare slum, Nairobi, and Tiva/Ithiani, Kitui.
- 342 children aged four to seven years were assessed for clinical signs and cytological features of VAD.
- Conjunctival Impression Cytology and Transfer (CICT) was employed to detect squamous metaplastic changes.
Main Results:
- While clinical signs of Xerophthalmia were minimal, CICT revealed high rates of abnormality (76.9%).
- Children in Mathare slum showed significantly higher VAD prevalence (only 13.2% normal CICT) compared to Kitui (50% normal CICT).
- Cytological evidence of VAD was significantly more prevalent in children from Mathare than Kitui.
Conclusions:
- Vitamin A deficiency (VAD) represents a significant public health problem in the assessed high-risk Kenyan communities.
- CICT is an effective tool for identifying subclinical VAD and guiding targeted interventions.
- The study underscores the disparity in VAD prevalence between urban slum and rural settings.
Objective:
To determine the prevalence of Xerophthalmia among Kenyan children aged four to seven years in high risk using Conjuctival Impression Cytology and transfer.
Design:
A cross sectional community based study.
Setting:
Mathare slum in Nairobi and Tiva/Ithiani area of Kitui.
Subjects:
Children aged four to seven years residing in the above areas were assessed for both clinical and cytological features of vitamin A deficiency.
Results:
Of the 342 children included in this study, 316 (92.0%) were normal, five (1.5%) had XN, 19 (5.9% had XIA and two (0.6%) had XIB. No signs of corneal Xerophthalmia were seen in this study. Conjuctival impression cytology and transfer (CICT) was used to asses for squamous metaplastic changes associated with Vitamin A deficiency (VAD). Seventy five (23.1%) of the children were normal by CICT while 249 (76.9%) were abnormal. In comparing the two areas of study, only 13.2% of the children in Mathare had normal CICT compared to 50% in Kitui. For each of the age groups studied there was significant difference between the two areas with children from Mathare being more deficient than those from Kitui.
Conclusion:
VAD is a significant health problem in the high risk areas assessed by CICT in this study.
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