Vitamin A deficiency in the Philippines: a study of xerophthalmia in Cebu

Abstract

An investigation of xerophthalmia was undertaken in four ecological zones in Cebu in the Philippines. One thousand seven hundred fifteen children aged 1 to 16 years were examined in 12 barrios. Clinical, biochemical and anthropometric data were collected from the children. Dietary and socioeconomic information was obtained from the households. Multivariate statistical techniques were used to examine factors possibly associated with xerophthalmia. Of children 47% had deficient or low serum vitamin A levels and 4.5% had clinical signs of xerophthalmia. Approximately 2% had both low serum vitamin A levels and clinical eye signs and were then defined as having active xerophthalmia. Vitamin A deficiency was more prevalent in males than females. Xerophthalmia was most common in the 4 to 6 year old age group. Diarrhea, roundworm infestation and measles were not positively correlated with xerophthalmia but whooping cough and tuberculosis were. Low intakes of carotene and vitamin A were associated with xerophthalmia but protein and fat intakes were not. A higher incidence of xerophthalmia occurred in children of working than nonworking mothers. Data on home production and use of vegetables and fruits are presented. The results of this study are being used to introduce three alternate intervention strategies to control xerophthalmia.

Subclinical vitamin A deficiency in Israeli-Bedouin toddlers

“…Evidence from human and animal studies suggests that males are more susceptible to VAD than females, for reasons that have not been elucidated (McLaren & Frigg, 2001). Data from previous studies indicate that xerophthalmia is 10 times more common in male than in females (Solon et al, 1978;Sommer, 1996). In addition, males have higher rates of VAD-associated mortality (Sommer et al, 1987).…”

Risk factors for nightblindness among women of childbearing age in Cambodia

“…Nightblindness is an early clinical manifestation of vitamin A deficiency among preschool children (Blankhart, 1967) and pregnant women in developing countries (Dixit, 1966) and has long been known to be associated with infectious diseases (Nylund, 1944). Among preschool children, nightblindness has been associated with increased diarrheal disease morbidity (Khan et al, 1984;Stoll et al, 1985) and tuberculosis (Solon et al, 1978). Nightblindness was associated with gastrointestinal and genitourinary infections among pregnant women (Christian et al, 1998a).…”

Infant feeding practices reflect antecedent risk of xerophthalmia in Nepali children

“…There is a large literature linking a low, current intake of vitamin A to xerophthalmia in preschool-aged children (Blankhart, 1967;Pepping et al, 1989Solon et al, 1978Sommer & West, 1996;Tarwotjo et al, 1982). The evidence to date is believed to re¯ect a pattern of chronically low vitamin A intakes.…”

“…As Sommer & West (1996) observe,`For many children, a weaning diet de®cient in vitamin A predicts a vitamin A de®cient diet through the rest of early childhood, and possibly beyond. ' Although most studies examining dietary patterns of children with night blindness have found signi®cant differences in consumption of preformed vitamin A (Shankar et al, 1996;Tarwotjo et al, 1982) and provitamin A food sources (Pepping et al, 1989;Solon et al, 1978;Tarwotjo et al, 1982), little evidence exists of the linkage between infant dietary intake of vitamin A food sources and later childhood xerophthalmia. An exception is a study by Mele et al (1991), which looked at xerophthalmic Indonesian children from 0±5 y (96% b 2 years) and matched controls, which found signi®cantly reduced risk of xerophthalmia in children whose mothers reported feeding them vitamin Arich foods regularly during the ®rst year of weaning.…”