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Risk factors associated with xerophthalmia in northern Sudan
P Nestel1, M G Herrera, A el Amin
1Harvard Institute for International Development, Cambridge, MA 02138.
Insights
Vitamin A deficiency affects 2.9% of Sudanese children, with Bitot's spots common. Interventions should focus on income and vitamin A-rich foods to reduce childhood deficiency.
Area of Science:
- Public Health
- Nutrition Science
- Ophthalmology
Background:
- Vitamin A deficiency is a significant global health concern, particularly in developing countries.
- Xerophthalmia, a severe eye condition resulting from vitamin A deficiency, can lead to irreversible blindness.
- Assessing the prevalence and risk factors of vitamin A deficiency in vulnerable populations is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of eye signs and symptoms of vitamin A deficiency in Sudanese children.
- To identify associated risk factors for xerophthalmia in the study population.
- To inform the development of effective intervention strategies.
Main Methods:
- A cross-sectional study was conducted among 29,615 Sudanese children aged 6-72 months in rural Khartoum and Gezira provinces.
- Data collection included clinical examination for eye signs of vitamin A deficiency and assessment of socio-economic and dietary factors.
- Statistical analyses, including bivariate and multivariate logistic regression, were used to identify risk factors.
Main Results:
- The prevalence of vitamin A deficiency was 2.9%, with over 90% of deficient children presenting with Bitot's spots.
- Significant risk factors for xerophthalmia included living in remote/arid regions, male gender, younger age, household poverty, and diarrhea prevalence.
- Consumption of dairy products and vitamin A-rich non-leafy vegetables in the preceding 24 hours was associated with reduced xerophthalmia.
Conclusions:
- Vitamin A deficiency remains a public health issue among Sudanese children, with specific socio-economic and environmental factors contributing to its risk.
- Targeted interventions should address household poverty and promote the intake of vitamin A-rich foods, including dairy and non-leafy vegetables.
- Improving household income and dietary diversity are key strategies for reducing vitamin A deficiency and preventing childhood blindness.
Abstract:
The prevalence of eye signs and symptoms of vitamin A deficiency was determined among 29,615 Sudanese children between 6 and 72 mo of age, in five rural areas of Khartoum and Gezira provinces. Of all children, 2.9% were vitamin A deficient, and of these > 90% had Bitot's spots. Bivariate associations were found between xerophthalmia and the rural councils where the children lived, household wealth, consumption of vitamin A-containing foods, child sex, child age and weight-for-height Z-scores. Multivariate analysis showed that the following factors made significant independent contributions to the risk of xerophthalmia: living in remote and arid regions, male gender, age, poverty of the household, and prevalence of diarrhea. On the other hand, less xerophthalmia was observed among children who during the 24 h preceding the survey had consumed dairy products or non-leafy vegetables containing vitamin A. Intervention programs aimed at increasing household income and promoting consumption of foods containing vitamin A should contribute to the reduction of vitamin A deficiency among Sudanese children.