title: Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India.
abstract: OBJECTIVE
  To assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children.
  
  
  METHODS
  A community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure.
  
  
  METHODS
  Rural areas of eight states in India.
  
  
  METHODS
  Pre-school children and their mothers were covered.
  
  
  RESULTS
  A total of 71,591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0·8%. The total ocular signs were significantly higher (P < 0·001) among boys (2·6%) compared with girls (1·9%) and in older children (3-4 years) compared (P < 0·001) with younger (1-2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR = 3·8; 95% CI 2·9, 5·0), labourers (OR = 2·9; 95% CI 2·1, 3·9), illiterate mothers (OR = 2·7; 95% CI 2·2, 2·3) and households without a sanitary latrine (OR = 5·9; 95% CI 4·0, 8·7). Subclinical VAD (serum retinol level <20 μg/dl) was observed in 62% of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58%.
  
  
  CONCLUSIONS
  The study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.
authors: Division of Community Studies, National Institute of Nutrition (Indian Council of Medical Research), Jamai-Osmania, Hyderabad 500 007, India. avulalaxman@yahoo.com
authors: Avula
authors: A
authors: Laxmaiah
authors: Madhavan K
authors: MK
authors: Nair
authors: Nimmathota
authors: N
authors: Arlappa
authors: Pullakhandam
authors: P
authors: Raghu
authors: Nagalla
authors: N
authors: Balakrishna
authors: Kodavanti Mallikharjuna
authors: KM
authors: Rao
authors: Chitty
authors: C
authors: Galreddy
authors: Sharad
authors: S
authors: Kumar
authors: Manachala
authors: M
authors: Ravindranath
authors: Varaganti Vikas
authors: VV
authors: Rao
authors: Ginnela N V
authors: GN
authors: Brahmam
mesh_terms: D015362:Child Nutrition Disorders / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D006920:Hygiene; D007194:India / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012423:Rural Health / Q000706:statistics & numerical data*; D012424:Rural Population; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D014801:Vitamin A / Q000008:administration & dosage* / Q000097:blood*; D014802:Vitamin A Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*
chemical_list: D014801:Vitamin A