Vitamin a deficiency and its risk factors among children aged 6 months to 15 years in Arssi Zone, Ethiopia

Abstract

A cross sectional study which was descriptive and analytical in nature was carried out between February and April 1999 among children aged 6 months to 15 years in Dodotana Sire district of Arssi zone, Ethiopia. The main objectives of this study was to determine the vitamin A status of pre-school and school aged children and, determine the risk factors of vitamin A deficiency in the study area. The methodologies used in data collection included administration of questionnaire, anthropometric measurements, clinical examination and serum retinol measurement and stool examination. A total of 402 children were included in the study. Food frequency data was collected from 350 randomly selected children. Serum retinol concentration was measured in 49 children, including those with xerophthalmia and every twentiet of the remaining children. Night blindness, Bitots spot, corneal xerosis, corneal ulceration and corneal scar were observed in 7.2%, 2.2 %, 0.2%, 0.5%, and 0.5% of the children respectively, based on the most severe eye signs. The prevalence of xerophthalmia was higher in school aged children than preschool children (P< 0.0001). Based on the WHO recommended cut-off level, serum retinol levels were in the "low" range «20fJ.l/dl) in 51% of the children. The mean frequency of consumption of animal sources of vitamin A was 1.5 days/week and weighted total of animal and plant sources of vitamin A was 1.9 days/week. Low frequency of consumption of vitamin A rich food was significantly associated with ocular signs of xerophthalmia (P<0.01). Of the under 10 years old children (305) 35.7% were stunted, 6.8% wasted and 5.6% both stunted and wasted. Intestinal parasites were observed in 16.6% of the children. The prevalence of diarrhea, respiratory tract infection and measles in the last one month was 10.2%,4.7% and 0.25% respectively. The prevalence of diarrhea was twice as high in children with xerophthalmia than children without (P<0.05). No statistically significant association was observed between respiratory tract infection or measles or intestinal parasite and occurrence of sign of xerophthalmia. Anthropometric measurements did not show significant association with clinical sings of vitamin A deficiency. The results therefore, indicate that vitamin A deficiency is a public health problem in the area with higher prevalence among school aged children than preschool children. Inadequate intake of vitamin A rich foods and diarrheal diseases were the most important risk factors for vitamin A deficiency in the study area. It is recommended that the on-going vitamin A capsule distribution program among the under six be strengthened and widened to include school children (up to 15 year olds) as a short-term intervention measure. However, increasing the availability and consumption of vitamin A rich foods through promotion of horticulture and nutrition education, and public health measures such as the control of diarrheal diseases, are the recommended as long-term control measures.