title: Clinical and sub-clinical vitamin A deficiency among rural pre-school children of Maharashtra, India.
abstract: BACKGROUND
  Although a national vitamin A prophylaxis programme has been in operation for more than three decades, vitamin A deficiency (VAD) continues to be a major nutritional problem of public health significance in India.
  
  
  OBJECTIVE
  The present study was carried out with the aim of assessing the prevalence of clinical and sub-clinical VAD among rural pre-school children.
  
  
  METHODS
  A community-based cross-sectional study was carried out in rural areas of Maharashtra State during 2002-2003. A total of 8646 pre-school children were examined for the presence of signs and symptoms of VAD. A sub-sample (494) of them was used to estimate blood vitamin A levels.
  
  
  RESULTS
  The prevalence of Bitot's spots (1.3%) and night blindness (1.1%) was higher than the WHO cut-off levels used to define a public health problem, and it increased significantly (p<0.001) with increase in age. The prevalence of Bitot's spots was 13 times higher among children belonging to the Scheduled Caste (OR=12.8), and 20 times higher among the children of labourers (OR=19.8). The prevalence of sub-clinical VAD (55%) was significantly (p<0.001) high among the children with night blindness (100%) and Bitot's spots (89%).
  
  
  CONCLUSIONS
  Increased vitamin A supplementation, health and nutrition education and consumption of vitamin A rich foods are essential to prevent VAD.
authors.affiliation: Division of Community Studies, National Institute of Nutrition (ICMR), Hyderabad, India. arlappan@yahoo.com
authors.forename: N
authors.initials: N
authors.lastname: Arlappa
authors.forename: A
authors.initials: A
authors.lastname: Laxmaiah
authors.forename: N
authors.initials: N
authors.lastname: Balakrishna
authors.forename: R
authors.initials: R
authors.lastname: Harikumar
authors.forename: G N V
authors.initials: GN
authors.lastname: Brahmam
mesh_terms: D000367:Age Factors; D015362:Child Nutrition Disorders / Q000150:complications / Q000453:epidemiology; D002675:Child, Preschool; D003229:Conjunctival Diseases / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009755:Night Blindness / Q000453:epidemiology / Q000209:etiology; D009749:Nutrition Surveys; D009752:Nutritional Status; D015995:Prevalence; D011897:Random Allocation; D012423:Rural Health / Q000706:statistics & numerical data; D012424:Rural Population; D012959:Socioeconomic Factors; D014801:Vitamin A / Q000097:blood; D014802:Vitamin A Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*
chemical_list: D014801:Vitamin A