title: Determinants of vitamin A deficiency amongst children in Aligarh District, Uttar Pradesh.
abstract: OBJECTIVE
  To determine the prevalence and determinants of xerophthalmia among children aged 0-60 months .
  
  
  METHODS
  This cross-sectional study included 3571 children under 5 years of age from six villages and four periurban areas. Children with xerophthalmia were identified and severity graded using the WHO classification. The main outcome measures were socio-demographic, nutritional and comorbidity related risk factors of xerophthalmia. A pretested questionnaire carrying information on the above factors was administered to the caregivers. Univariate and multivariate binary logistic regression analyses were performed to examine the association of each of these factors with xerophthalmia.
  
  
  RESULTS
  The overall prevalence of xerophthalmia was of serious public health importance at 9.1%. Prevalence of both mild (night blindness, and Bitots spots) and severe forms (corneal changes) of xerophthalmia increased with age. Bitots spots and night blindness were the commonest manifestations. Rural dwelling, lower social class, maternal illiteracy and occupation outside home were significant antecedent socio-demographic risk factors on univariate analysis. Multivariate analysis revealed low intake of proteins and vitamin A containing foods as well as predominant maize diet to be significant dietary factors. Nutritional wasting and a preceding history of measles were significant comorbid determinants (P<0.05). None of the socio-demographic variables emerged significant on multivariate analysis.
  
  
  CONCLUSIONS
  Vitamin A deficiency remains a significant public health problem in Aligarh district. The proximal factors in a child's milieu viz nutrition and comorbidities were more significantly associated with xerophthalmia than the distal socio-demographic factors, thereby making a case for their cost effective prevention. The high magnitude of the problem calls for intensification of existing prophylactic measures in these areas.
authors.affiliation: Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India. sandeepsemail@rediffmail.com
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sachdeva
authors.forename: Seema
authors.initials: S
authors.lastname: Alam
authors.forename: Farzana K
authors.initials: FK
authors.lastname: Beig
authors.forename: Zulfia
authors.initials: Z
authors.lastname: Khan
authors.forename: Najam
authors.initials: N
authors.lastname: Khalique
mesh_terms: D001766:Blindness / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D009755:Night Blindness / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D014802:Vitamin A Deficiency / Q000453:epidemiology*; D014985:Xerophthalmia / Q000453:epidemiology*