Risk factors for developing mild nutritional blindness in urban Bangladesh
B. F. Stanton, J. D. Clemens, B. Wojtyniak and T. Khair
Mild vitamin A deficiency may be associated with increased morbidity and
mortality among children in developing countries. A community-based
case-control study was performed to determine risk factors for mild
ophthalmologic manifestations of vitamin A deficiency in urban Bangladeshi
children. Cases were identified in children less than 14 years of age with
night blindness with or without other signs of mild xerophthalmia detected
in a house-to-house survey. Controls were randomly selected neighbors who
lacked subjective and objective ophthalmologic evidence of vitamin A
deficiency. Demographic characteristics that were independently associated
with vitamin A deficiency in a logistic model included male gender, greater
age (mean, 6.1 years in children with cases and 2.8 years in controls), and
a greater number of children living with the family. After controlling for
these demographic characteristics, poor intake of locally available vitamin
A-rich foods, cessation of breast-feeding, and a recent history of
protracted diarrhea remained associated with vitamin A deficiency. Maternal
ignorance of prevention and control of vitamin A deficiency was also
associated with increased risk. The results support programs that educate
mothers to breast-feed and to provide appropriate food supplements and
suggest that clinicians caring for children with chronic diarrhea should
initiate vitamin A supplementation.
