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Childhood blindness due to vitamin A deficiency in India: regional variations
J S Rahi1, S Sripathi, C E Gilbert
1International Centre for Eye Health, Department of Preventive Ophthalmology, London.
Insights
Vitamin A deficiency is the leading cause of childhood blindness and severe visual impairment (SVI) in India. This condition affects 18.6% of visually impaired children, with significant regional and urban-rural disparities.
Area of Science:
- Ophthalmology
- Public Health
- Nutritional Science
Background:
- Childhood blindness and severe visual impairment (SVI) pose significant public health challenges globally.
- Vitamin A deficiency is a known preventable cause of childhood blindness, particularly in low-income countries.
- Understanding the prevalence and distribution of vitamin A deficiency-related visual impairment in India is crucial for targeted interventions.
Purpose of the Study:
- To determine the extent to which vitamin A deficiency contributes to childhood blindness and SVI in India.
- To identify geographical and locational variations in the prevalence of this condition.
Main Methods:
- A cross-sectional survey was conducted among children with visual acuity less than 6/60 in the better eye.
- The study included 1318 children attending 22 schools for the blind across nine Indian states.
- The primary outcome measure was the proportion of blindness or SVI attributable to corneal scarring from vitamin A deficiency.
Main Results:
- Vitamin A deficiency was identified as the cause of SVI/blindness in 245 out of 1318 children (18.6%).
- The prevalence varied significantly across states, ranging from 7.5% in Kerala to 26.7% in Madhya Pradesh.
- A notable difference was observed between urban and rural areas within Tamil Nadu, with 30.4% in a rural school compared to 7.5% in the capital city's school.
Conclusions:
- Vitamin A deficiency is the predominant cause of childhood blindness and SVI throughout India.
- Significant regional disparities exist in the prevalence of vitamin A deficiency-related visual impairment.
- Urban versus rural differences highlight the need for context-specific public health strategies to combat this preventable condition.
Objectives:
To investigate the importance of vitamin A deficiency as a cause of childhood blindness and severe visual impairment (SVI) in India.
Design And Setting:
Cross sectional survey of children with visual acuity less than 6/60 in the better eye (SVI/blindness), attending 22 schools for the blind in nine states of India.
Main Outcome Measure:
Proportion of children with blindness or SVI from corneal scarring attributable to vitamin A deficiency.
Results:
245 of 1318 (18.6%) of children had SVI/blindness attributable to vitamin A deficiency. The proportion of SVI/blindness due to vitamin A deficiency ranged from 7.5% (7/93) in Kerala to 26.7% (27/101) in Madhya Pradesh. In Tamil Nadu, 7.5% (9/120) of children in the capital city blind school had SVI/blindness due to vitamin A deficiency, compared with 30.4% (51/168) in a blind school in a rural area of the same state.
Conclusion:
Overall, vitamin A deficiency is the single most important cause of childhood blindness and SVI in India. There are marked variations by state and also between urban and rural locations.