Risk factors for nightblindness among women of childbearing age in Cambodia

Abstract

Objective: To characterize risk factors for nightblindness among nonpregnant women of childbearing age, a group recently recognized to be at high risk of vitamin A deficiency in some developing countries. Design: Case-control study. Setting: The study included 415 000 households in National Micronutrient Survey of Cambodia conducted in 2000. Subjects: The prevalence of nightblindness among 13 358 nonpregnant women was 2.0%. A total of 328 nonpregnant women with nightblindness were matched by province with 1009 nonpregnant women without nightblindness. Methods: Univariate and multivariate logistic regression models were used to estimate odds ratios (ORs) as estimates of the relative risk of factors associated with nightblindness. Results: In a final model, materials in the wall of the house (OR 1.4, 95% confidence interval (CI) 0.9-2.0), land ownership r0.5 hectares (OR 1.4, 95% CI 1.0-1.9), nightblindness in last pregnancy (OR 44.5, 95% CI 29.2-67.8), parity 43 (OR 1.5, 95% CI 1.0-2.1), diarrhea within the last 2 weeks (OR 1.9, 95% CI 1.3-2.8), maternal body mass index o18.5 (OR 1.8, 95% CI 1.2-2.7), and lack of consumption of vitamin A-rich animal foods in the last 24 h (1-60 retinol equivalents (RE) OR 1.1 , 95% CI 0.7-1.6; Z60 RE, OR 0.7, 95% CI 0.4-1.0) were associated with nightblindness among nonpregnant women. Conclusions: Women of childbearing age in Cambodia with low socioeconomic status, low consumption of vitamin A-rich animal foods, a history of nightblindness during the previous pregnancy, parity 43, malnutrition, and diarrhea have a higher risk of nightblindness. Sponsorship: United States Agency for International Development (442-G-00-95-00515-00).

Night Blindness is a Serious Public Health Problem of Pregnant Women’s in Tahtay Koraro District, Tigray Region, Northern Ethiopia

“…It is consistent with a study in rural Cambodia which reports pregnant mothers with lower socioeconomic status are at higher risk for night blindness than those with higher socio economic-status [18]. This could be due to those who have high socio-economic states can get or consume vitamin A rich foods than the poorest and/or may have economically strong woman's may have used health services than the poor.…”

Vitamin A Deficiency

“…A similar parent-child intensity of clustering has been observed in Cambodia, where young children were four or five times more likely to have xerophthalmia when the mother was night blind, who in turn was nine times more likely to be night blind if one of her children had xerophthalmia [87]. This high level of shared risk of vitamin A deficiency is likely due to common exposures to a chronic poor diet [204,205] and inadequate care, malnutrition, and disease that characterize mothers [206] and children 1 Numbers of children <6 years of age in each country: Malawi (n = 5441); Zambia (n = 4316); Indonesia (n = 28,586); and Nepal (n = 4764). 2 Pairwise odds ratio based on alternating logistic regression.…”

“…infection [12,206]. Typically, odds ratios (ORs) for xerophthalmia lie between 1.5 and 2.5 when comparing risks among families with lower versus higher SES.…”

“…Maternal night blindness is likely due to maternal vitamin A deficiency as it often develops late in pregnancy [12], when serum retinol is low [152], and then typically resolves within days after childbirth. The condition is associated with a poor diet, anemia, wasting undernutrition, and increased occurrence of diarrhea and other morbid symptoms [12,149,150,153].…”

“…In rural South Asia [147][148][149][150] and subSaharan Africa [1] and in poor, urban areas of Latin America [1,151], 10-20% of women have reported night blindness in pregnancy. Maternal night blindness is likely due to maternal vitamin A deficiency as it often develops late in pregnancy [12], when serum retinol is low [152], and then typically resolves within days after childbirth.…”