Serum Vitamin A Levels and Xerophthalmia among Children with Protein Energy Malnutrition in Zaria, Northwest Nigeria

Main Article Content

Asimau Eivovo Idris Zubairu
Kehinde Kabir Oladigbolu
Hawwa Salihu Abdullahi
Elijah Ndako Peter
Halima Olufunmilola Abdulsalam
Hafsatu Maiwada Suleiman

Keywords

Protein-energy malnutrition, vitamin A deficiency, xerophthalmia

Abstract

Background: Protein-energy malnutrition (PEM) is one of the major risk factors for vitamin A deficiency (VAD), which may be complicated by xerophthalmia. There have been several interventions employed to tackle VAD in our environment. However, there are limited recent local studies assessing the interplay between VAD and the burden of xerophthalmia in under-five children with PEM. The study aims to determine the association between serum vitamin A levels and xerophthalmia among under-five children with PEM.


Methodology: This was a prospective cross-sectional study conducted among 200 children between the ages of 6 to 59 months newly diagnosed with protein-energy malnutrition at the study centre. Data was collected using a structured proforma, which included sociodemographic variables and ocular examination findings. Blood samples were collected to analyse serum vitamin A levels using an ELISA kit (Aviva systems®).


Results: There were 153 (76.5%) children with PEM who had low serum vitamin A levels. Xerophthalmia was found in 12 (6%) children. Xerophthalmia was only seen in those with low serum vitamin A and was statistically significantly higher in children with very low levels of vitamin A (1.5% vs 12.9%, p = 0.002). Blinding forms of xerophthalmia were seen in 3 (1.5%) of the children.


Conclusion: The prevalence of vitamin A deficiency and xerophthalmia is still considerably high and of public health significance among children with PEM in our environment.   

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References

1. Kundu S, Rai B, Anandi S. Prevalence and determinants of vitamin A deficiency among children in India: Findings from a national cross-sectional survey. Clin Epid Global Health 2021; 11: 2213-3984j

2. Abdullahi SM, Yakubu AM, Bugaje MA, Akuyam SA. Serum vitamin A levels among malnourished children aged 6 – 59 months in Zaria. Niger J Paediatr 2017; 44(3): 152-156

3. Gilbert C. The eye signs of vitamin A deficiency. Community Eye Health 2013; 26(84): 66-67

4. Sommer A, Tarwotjo I, Hussaini G, Susanto D. Increased mortality in children with mild vitamin A deficiency. Lancet. 1983; 2(8350): 585–588

5. Cohen N, Rahman H, Sprague J, et al. Prevalence and determinants of nutritional blindness in Bangladeshi children. World Health Stat Q. 1985; 38(3): 317–330

6. Song P, Adeloye D, Li S, Zhao D, Ye X, Pan Q, et al. The prevalence of vitamin A deficiency and its public health significance in children in low- and middle-income countries: A systematic review and modelling analysis. J Glob Health. 2023 Aug; 13:04084. doi:10.7189/jogh.13.04084

7. Ubesie AC, Ibeziakor NS. High burden of Protein energy malnutrition in Nigeria: Beyond the healthcare setting. Ann Med Health Sci Res. 2012 Jan-Jun; 2(17)

8. Boro A, Keita F, Sidibe F, Traore F, Thera D, Kourekama I, Napo A. Ocular Manifestations in Severe Acute Malnutrition in Children under 60 Months in a Secondary Health Centre. Open Journal of Ophthalmology 2023; 13: 288-294.

9. Hamidu JL, Salami HA, Ekanem AH, Hamman L. Prevalence of protein – energy malnutrition in Maiduguri, Nigeria. African Journal of Biomedical Research, 2003; 5(3). DOI:10.4314/ajbr.v6i3.54039

10. Chukwuemeka KJ, Agozie UC, Kunle OE. Under five malnutrition in a South Eastern Nigeria Metropolitan city. Afr Health Sci. 2019 Dec; 19(4): 3078 – 3084.

11. Oso OO, Abiodun PO, Omotade OO, Oyewole D. Vitamin A status and nutritional intake of carotenoids of preschool children in Ijaye-Orile community in Nigeria. J Trop Pediatr. 2003 Feb; 49(1): 42-47. Doi: 10.1093/tropej/49.1.42.PMID: 12630720.

12. Schemann JF, Banou A, Malvy D, Guindo A et al. National immunisation days and vitamin A distribution in Mali: has the vitamin A status of preschool children improved? Public Health Nutrition, 2003; 6(3): 233-240.

13. Medani Ahmed UB. Ocular manifestations of severe protein energy malnutrition in Sudanese children (master’s thesis on the internet). Khartoum: University of Khartoum, 2003. Available from https://khartoumspace.uofk.edu. Date assessed 7th June, 2019.

14. Singh P, Kumar R, Das S. A clinical study of prevalence of ocular manifestations in malnourished children attending Anganwadi centres in urban slum areas. Int J Med Res Rev 2017; 5(11): 956-961. doi:10.17511/ijmrr.2017.i11.07

15. Belete GT, Fenta AL, Hussen MS. Xerophthalmia and Its Associated Factors Among School-Age Children in Amba Giorgis Town, Northwest Ethiopia. Journal of Ophthalmology, 2019.Article ID 5130904, 8 pages.

16. Hwei Seng KB, Tan PY, Lim CC, Loganathan R, et al. High prevalence of xerophthalmia linked to socio-demographic and nutritional factors among vitamin A-deficient rural primary school children in Malaysia. Nutrition Research 2024; 131: 14-26