Working after the sun goes down: Exploring how night blindness impairs women’s work activities in rural Nepal

Christian, Parul; Thorne‐Lyman, Andrew L.; West, Keith P.; Bentley, Margaret E.; Sk, Khatry; Pradhan, Elizabeth Kimbrough; LeClerq, S. C.; Shrestha, S. R.

doi:10.1038/sj.ejcn.1600600

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…Nightblindness is a debilitating disorder for pregnant women in Nepal, which negatively affects their quality of life (48) and increases the risk of mortality of their infants by 63% in the first 6 mo of life (49). This study shows that nutrient deficiencies in addition to vitamin A deficiency must be involved.…”

Section: Discussionmentioning

confidence: 99%

Supplementation with iron and riboflavin enhances dark adaptation response to vitamin A–fortified rice in iron-deficient, pregnant, nightblind Nepali women

Graham

Haskell

Pandey

et al. 2007

The American Journal of Clinical Nutrition

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Background: Nightblindness affects 16 -52% of pregnant women in areas of Nepal and in some cases persists after vitamin A treatment. Iron and riboflavin affect vitamin A utilization and photoreceptor function, respectively, and pilot data in the study population showed a high prevalence of iron and riboflavin deficiencies. Objective: The objective was to assess the effect of supplemental iron and riboflavin on pupillary threshold (PT) and plasma retinol in nightblind, pregnant Nepali women given vitamin A-fortified rice. Design: Nightblind pregnant women were randomly assigned to receive, 6 d/wk under supervision for 6 wk, a vitamin A-fortified rice curry dish providing 850 g retinal activity equivalents/d with either a 30-mg Fe and 6-mg riboflavin (FeR ѿ VA) capsule or a placebo control (VA only) capsule. Hemoglobin, erythrocyte riboflavin, and plasma ferritin and retinol were measured before and after the intervention. Dark adaptation was assessed by PT score. Results: Women who were iron deficient at baseline (n ҃ 38) had significantly greater improvement in PT score with iron and riboflavin supplementation than without (P ҃ 0.05). Iron and riboflavin supplements significantly reduced the prevalences of riboflavin deficiency (from 60% to 6%; P 0.0001), iron deficiency anemia (from 35% to 15%; P 0.007), and abnormal PT (from 87% to 30%; P 0.05) from baseline. Mean increases in erythrocyte riboflavin (P 0.0001) and plasma ferritin (P ҃ 0.01) were greater in the FeR ѿ VA group than in the VA only group. Conclusions: Iron deficiency may limit the efficacy of vitamin A to normalize dark adaptation in pregnant Nepali women. Further studies are needed to assess the effect of simultaneous delivery of iron and vitamin A for the treatment of nightblindness.Am J Clin Nutr 2007;85: 1375-84.

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Section: Discussionmentioning

confidence: 99%

Supplementation with iron and riboflavin enhances dark adaptation response to vitamin A–fortified rice in iron-deficient, pregnant, nightblind Nepali women

Graham

Haskell

Pandey

et al. 2007

The American Journal of Clinical Nutrition

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Risk Factors for Maternal Night Blindness in Rural South India

Katz¹,

Tielsch²,

Ravilla³

et al. 2009

Ophthalmic Epidemiology

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Purpose This study aimed to identify risk factors associated with maternal night blindness in rural South India. Methods At delivery, women enrolled in a population-based trial of newborn vitamin A supplementation were asked whether they were night blind at any time during the pregnancy. Multivariate logistic regression was used to identify socioeconomic, demographic, and pregnancy related factors associated with maternal night blindness. Results Women reported night blindness in 687 (5.2%) of 13,171 pregnancies. In a multivariate model, having a concrete roof (Odds Ratio (OR): 0.60, 95% Confidence Interval (CI): 0.47, 0.78), religion other than Hindu (OR: 0.46, 95% CI: 0.27, 0.76), maternal literacy (OR: 0.58, 95% CI: 0.49, 0.69), and maternal age from 25 to 29 years (OR: 0.68, 95%CI: 0.50, 0.93) were associated with a lower risk of night blindness in pregnancy. The odds of night blindness were higher for those leasing rather than owning land (OR: 1.78, 95%CI: 1.08, 2.93), parity 6 or more compared to 0 (OR: 2.11, 95% CI: 1.09, 4.08), and with twin pregnancies (OR: 3.23, 95% CI: 1.93, 5.41). Factors not associated with night blindness in the multivariate model were other markers of socioeconomic status such as electricity in the house, radio and television ownership, type of cooking fuel, and household transportation, and number of children under 5 years of age in the household. Conclusions Maternal night blindness was prevalent in this population. Being pregnant with twins and of higher parity put women at higher risk. Maternal literacy and higher socioeconomic status lowered the risk.

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Social Factors Determining the Experience of Blindness among Pregnant Women in Developing Countries: The Case of India

Pandey

Lin

Collier-Tenison

et al. 2012

Health & Social Work

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Approximately 10 million pregnant women around the world develop night blindness annually. In India, one in 11 pregnant women suffers from night blindness. This study used a nationally representative sample of 35,248 women from India between the ages of 15 and 49 who had given birth in the past five years to understand the effect of women's empowerment on developing blindness during pregnancy. Findings from logistic regression showed that several empowerment-related factors, including women's increased age at the birth of their first child, high school education, and participation in their own health care decisions, significantly reduced the odds of developing blindness, whereas their experience of spousal control, humiliation, and physical abuse significantly increased the odds of developing blindness during pregnancy. Interestingly, antenatal care visits that included nutritional advice and iron supplements during pregnancy had no effect on blindness after controlling for other factors. To reduce blindness during pregnancy in India, more attention should be given to delaying age at marriage and first birth; improving women and girl's education and autonomy; and implementing strategies to reduce spousal control, humiliation, and abuse.

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Working after the sun goes down: Exploring how night blindness impairs women’s work activities in rural Nepal

Cited by 4 publications

References 15 publications

Supplementation with iron and riboflavin enhances dark adaptation response to vitamin A–fortified rice in iron-deficient, pregnant, nightblind Nepali women

Supplementation with iron and riboflavin enhances dark adaptation response to vitamin A–fortified rice in iron-deficient, pregnant, nightblind Nepali women

Risk Factors for Maternal Night Blindness in Rural South India

Social Factors Determining the Experience of Blindness among Pregnant Women in Developing Countries: The Case of India

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