ASSOCIATION BETWEEN VITAMIN A AND D DEFICIENCY AND OCULAR MORBIDITY IN UNDER-FIVE CHILDREN IN RURAL COMMUNITIES
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Keywords
Vitamin A deficiency; Vitamin D deficiency; Ocular morbidity; Under-five children; Rural communities; Dera Ismail Khan.
Abstract
Background: Vitamin A and D deficiencies remain major public-health challenges in many developing regions, particularly in rural communities where poverty and inadequate diet are widespread. Both micronutrients play vital roles in maintaining vision and immune function. Deficiencies during early childhood can lead to ocular morbidity, including xerosis and night blindness, which contribute to preventable visual impairment.
Methodology: A community-based cross-sectional study was carried out from January 2024 to January 2025 in the rural areas under the catchment of Gomal Medical College, Dera Ismail Khan. A total of 72 children under five years of age were selected through multistage random sampling. Data were collected using a structured questionnaire, clinical eye examination, and biochemical analysis of serum vitamin A and D levels. Statistical analysis was performed using SPSS 25. The chi-square test was applied to examine associations between vitamin deficiencies and ocular morbidity, with a p-value < 0.05 considered significant.
Results: Among the 72 children, 43.1% were deficient in vitamin A and 50% in vitamin D. One-fourth of the children (25%) exhibited ocular morbidity, the most common being conjunctival xerosis and night blindness. A significant association was observed between vitamin A deficiency and ocular morbidity (p = 0.004) as well as between vitamin D deficiency and ocular morbidity (p = 0.006). Children deficient in both vitamins showed the highest risk, and the combined deficiency had a highly significant relationship with ocular morbidity (p = 0.001).
Conclusion: This study demonstrates that vitamin A and D deficiencies are prevalent among under-five children in rural Dera Ismail Khan and are strongly associated with ocular morbidity. Addressing these deficiencies through regular supplementation, nutrition education, and improved dietary practices could substantially reduce preventable childhood eye diseases.
References
2. Hossain, M.M., et al., Rural-urban determinants of vitamin a deficiency among under 5 children in Bangladesh: Evidence from National Survey 2017–18. 2021. 21(1): p. 1569.
3. Sahile, Z., et al., Prevalence of vitamin a deficiency among preschool children in Ethiopia: A systematic review and meta‐analysis. 2020. 2020(1): p. 8032894.
4. Bora, K.J.B.g.h., Vitamin A supplementation among 9-59 month old children in India: geospatial perspectives and implications for targeted coverage. 2022. 7(7): p. e007972.
5. Abdi, N.I., Assessment of Vitamin A Routine Supplementation and Diet Rich in Vitamin A on Nutrition Status in Under Five Years of Age in Wajir East Sub-County. 2020, KeMU.
6. Zegeye, B., et al., Trends in inequality in the coverage of vitamin A supplementation among children 6–59 months of age over two decades in Ethiopia: evidence from demographic and health surveys. 2022. 10: p. 20503121221094688.
7. Nigusse, T. and A. Gebretsadik, Research Article Vitamin A Supplementation Coverage and Ocular Signs among Children Aged 6–59 Months in Aleta Chuko Woreda, Sidama Zone, Southern Ethiopia. 2021.
8. Irshad, S.J.I.J.o.R.R.i.L.S., Prevalence of Night Blindness due to vitamin A deficiency in Pakistan: An overview. 2022. 9(1): p. 1-9.
9. Xu, Y., et al., Global patterns in vision loss burden due to vitamin A deficiency from 1990 to 2017. 2021. 24(17): p. 5786-5794.
10. Chineka, A., Determinants of Vitamin A Adherence in Children Aged 6-59 Months in Murehwa District, Zimbabwe. 2022.
11. Kundu, S., et al., Prevalence and determinants of Vitamin A deficiency among children in India: Findings from a national cross-sectional survey. 2021. 11: p. 100768.
12. Faye, M.H., et al., Prevalence and associated factors of vitamin A deficiency among children and women in Senegal. 2020. 8(2): p. 1-11.
13. Imdad, A., et al., Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. 2022(3).
14. Devidas, J., et al., Socio-demographic and morbidity pattern among under-five children in rural areas of Adilabad District of Telangana, India. 2021. 15(10): p. 17-21.
15. Marjan, N., et al., Factors associated with coverage of vitamin a supplementation among Bangladeshi children: mixed modelling approach. 2021. 21(1): p. 648.
16. Ranjan, A., et al., Pattern of Ocular Morbidity in School Going Children. 2020. 9(39): p. 2870-2874.
17. Ekholuenetale, M., et al., Socioeconomic inequalities in hidden hunger, undernutrition, and overweight among under-five children in 35 sub-Saharan Africa countries. 2020. 95(1): p. 9.
18. Ba, A., et al., Prevalence and associated risk factors of Vitamin D deficiency in children under five years of age, at the Diamniadio Childrens Hospital in Senegal. 2022. 16(4): p. 47-54.
19. Mathad, V.S., N.S. Mahanshetti, and V.A.J.M.J.o.M.S. Naik, Impact of morbidity among under-five children: A meta-analysis. 2022. 9(1): p. 112-119.
20. Nduhukire, T., et al., Predictors of in-hospital mortality among under-five children with severe acute malnutrition in South-Western Uganda. 2020. 15(6): p. e0234343.
21. Raichandani, D., et al., Current Scenario of Ocular Morbidity in Severe Acute Childhood Malnutrition in Central Part of India. 2022. 8(1): p. 130-136.
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Muhammad Ayub Khan
Assistant Professor, Department of Ophthalmology, Gomal Medical College, Dera Ismail Khan, Pakistan
Muhammad Irfan
Senior Registrar, Department of Ophthalmology, HBS Medical & Dental College, Islamabad, Pakistan
Junaid Afsar Khan
Assistant Professor, Department of Ophthalmology, CMH Medical College & IOD Lahore, Pakistan
Muhammad Numan
Assistant Professor, Department of Ophthalmology, Bannu Medical College, Bannu, Pakistan
Roomana Anwar
Associate Professor, Department of Biochemistry, HBS Medical and Dental College, Islamabad, Pakistan
Erum Tariq
Assistant Professor, Department of Biochemistry, Quetta College of Dentistry, QCD, Quetta, Pakistan