Risk factors for xerophthalmia were assessed in 466 subjects [38% with night blindness (XN), 60% with Bitot's spots (X1B), 2% with corneal xerophthalmia (X2 or X3)] under age 6 y and their village-age-sex-matched control subjects during a community trial. Socioeconomic status and hygiene standards were lowest for households of xerophthalmic children and highest for nonstudy households in the trial population, with values for control households lying in between (P less than 0.001 by linear trend). Risk of xerophthalmia increased with less frequent consumption of dark green leaves, yellow fruits, or egg during weaning, adjusted for current intake and present age [odds ratio (OR) = approximately 3.5]. Exclusion of these same foods from the current diet (except for mango and papaya in older children) was associated with a two- to ninefold excess risk of xerophthalmia, adjusted for weaning influences. Xerophthalmic children aged less than 3 y were generally at higher risk of dietary imbalance than were older children. Xerophthalmia is associated with a chronic, infrequent consumption of key vitamin A foods from weaning through early childhood.
A randomized community trial was carried out in Aceh, Indonesia, 1982-1984, to assess the impact of semiannual vitamin A (VA) supplementation (60,000 micrograms RE) on preschool child growth: 229 villages were randomized to VA program and 221 to control status. One thousand thirty-two program and 980 control children aged 1-5 y were assessed and followed for 12 mo. VA program males gained an additional approximately 110 g weight at age 2-3 y (NS), 190 g at age 4 y (p less than 0.05), and 263 g at age 5 y over control males (p less than 0.01). Arm circumference and muscle area expanded 2 mm (p less than 0.05) and approximately 36 mm2 (p less than 0.05) more per year, respectively, from ages 3 to 5 y of age and more arm fat was retained at every age (p less than 0.05 at 1 and 3 y) in VA males. There were no group differences in ponderal growth for females or in linear growth for either sex. VA supplementation may improve growth where endemic deficiency exists.
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