Prevalence of vitamin A deficiency and its determinants among the rural pre-school children of Madhya Pradesh, India

Background: Vitamin A deficiency (VAD) continues to be a major public health nutritional problem in India, even though the National Vitamin A Prophylaxis Programme has been in operation for more than three decades. Aim: To assess the prevalence of vitamin A deficiency among rural pre-school children. Subjects and methods: A community-based cross-sectional study was carried out in rural Madhya Pradesh. A total of 8777 pre-school children were clinically examined for VAD and blood vitamin A levels were estimated in a sub-sample by dried blood spot method. Results: Prevalence of night blindness and Bitot's spot, an objective sign of VAD, was 0.8% and 1.4%, respectively, and prevalence increased significantly (p < 0.001) with age. The proportion of children with blood vitamin A deficiency (< 20 mu g/ dL) was 88% (95% CI: 84.8-91.2). The prevalence of Bitot's spot was significantly (p, 0.001) higher among children of lower socio-economic communities, 3-5-year age group and those of illiterate mothers. Conclusions: VAD is a major public health problem among rural children of Madhya Pradesh. Children of 3-5 years and those belonging to lower socio-economic communities are at high risk of VAD. Therefore, appropriate intervention measures are to be initiated to improve the vitamin A status of children.