1. SUBCLINICAL VITAMIN A DEFICIENCY AND THE MORBIDITY PATTERN OF CHILDREN 1-5 YEARS IN A RURAL COMMUNITY OF JAMMU Suri Shivalia, Kumar Dineshb, Das Ranjanc, Rasania SKd a Senior Resident, Lady Hardinge Medical College & Associated Hospitals; b Head of Department, Government Medical College & Associated Hospitals, Jammu & Kashmir; c Professor, Lady Hardinge Medical College & Associated Hospitals; d Director Professor and Head, Lady Hardinge Medical College & Associated Hospitals
Abstract
Observations
Results
A large proportion of preschool children (62%) continue to suffer from subclinical Vitamin A Deficiency (Sc VAD). This cross-sectional study was conducted in Block R.S.Pura (J&K) among children aged 1-5 years. VAD was observed in 73% of villages. 28.4% children were suffering from some degree of under-nutrition. In almost all villages found to be at risk of VAD, rates of morbidities (diarrhoea, ARI, measles and malnutrition) were quite high.
I. Distribution of surveyed population
Percentage
Out of 750 children surveyed, 58.4% were boys and rest were girls
Highest percentage of children were in the age groups of 1-2 years (33.5%) and 2-3 years (32.1%)
84.5% of children belonged to the Middle Socio-economic Status as per Modified Uday Pareek Scale
Nutritional status (mid- upper arm circumference)- one-fourth of them were suffering from under-nutrition
The whole block of R.S.Pura was considered to have sub-clinical VAD since 11 out of the 15 villages studied (73.3%) were found to be deficient in their consumption of Vitamin A rich foods
21.5% children had a history of diarrhoea, 39.1% had a history of ARI and 1.2% had history of measles
100% = 750
49-60 mo
12-24 mo
Girls
37-48 mo
Introduction
Boys
Vitamin-A is an essential nutrient needed for normal functioning of visual system, growth, epithelial integrity, etc.
India: improvement in Vitamin A status of preschool children, 62% still suffer from subclinical VAD, causing severe public health problem
Sub Clinical VAD causes increased susceptibility to infections, morbidity and mortality from respiratory and intestinal infections
25-36 mo
II. Episodes of diarrhea, measles, and ARI in surveyed population
Number of children
Discussion
HKI is a simple, inexpensive, user-friendly screening tool for sub-clinical VAD
Subclinical VAD by HKI food frequency questionnaire & serum retinol levels agree well
The high incidence of diarrhoea, ARI & measles in under-fives could have worked in tandem to produce VAD
In almost all villages which were found to be at risk of VAD, the rates of the morbidities (diarrhoea, ARI, measles and malnutrition) were quite high.
Limitation of study : Estimation of serum retinol could not be done
Total
ARI
Objectives
Diarrhea
To assess subclinical VAD and study morbidity pattern of children aged 1-5 years in a rural area of Jammu
Measles
Villages
Methodology
III. Results of HKI methodology - 11 of 15 (73%) villages had ScVAD
Vitamin-A deficiency if a ≤ 4 or d ≤ 6
The cross-sectional study was conducted in Block R.S.Pura as per standard methodology (Vitamin A Technical Assistance Program)
15 villages were selected and 50 children aged 1-5 years were included from each village
Mothers of children (750) were interviewed regarding frequency of consumption of 28 food items in Helen Keller International Food Frequency Questionnaire
History of diarrhoea, cough, fever and measles was recorded
To assess nutritional status of child, mid upper arm circumference was measured
Animal source
Plant source
VAD Villages
Conclusion
Animal source cut-off (d)
Long-term measures e.g. IEC on appropriate diets to be given equal priority with Vitamin A supplementation
HKI Food Frequency Questionnaire may be promoted as field technique for assessing subclinical VAD.
Plant source cut-off (a)
Villages
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