1. High prevalence of xerophthalmia linked to socio-demographic and nutritional factors among vitamin A-deficient rural primary schoolchildren in Malaysia.
- Author
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Seng, Katherine Boon Hwei, Tan, Pei Yee, Lim, Chuan Chun, Loganathan, Radhika, Lim, Yvonne Ai-Lian, Teng, Kim-Tiu, Selvaduray, Kanga Rani, Mohd Johari, Syahirah Nadiah, and Mohd Ramli, Norlina
- Abstract
• This study includes 596 children with 26.5% having confirmed vitamin A deficiency. • Xerophthalmia is highly prevalent (48.8%) in this study population. • The most common ocular sign in this study population is conjunctival xerosis (38.9%). • Boys and indigenous schoolchildren have higher risk of xerophthalmia. • Overweight/obesity status is associated with a reduced risk of xerophthalmia. • Identified risk factors linked to xerophthalmia aid in targeted intervention efforts. Vitamin A deficiency (VAD) remains a major health issue in developing nations, contributing to preventable childhood blindness. However, there is lack of recent data on xerophthalmia, especially among school-aged children in Malaysia. We hypothesized that xerophthalmia persists among rural schoolchildren in Malaysia and potentially associated with socio-demographic status and malnutrition. We conducted a cross-sectional study on 596 schoolchildren (8-12 years) from ten rural primary schools located in five states across Malaysia. Children meeting the criteria for xerophthalmia assessment included those diagnosed with vitamin A deficiency (VAD) (plasma retinol < 0.70 µmol/L) and marginal VAD (plasma retinol 0.70 to < 1.05 µmol/L). The overall prevalence of xerophthalmia was 48.8%, with the most common ocular sign being conjunctival xerosis (38.9%). The occurrence of xerophthalmia was negatively associated with retinol-binding protein 4 (RPB4) (P =0.003), alpha-carotene (P =0.04), hemoglobin (P =0.004), weight (P =0.02), body mass index (BMI) (P =0.04) and WAZ (weight-for-age z-score) (P =0.04) status. Based on multivariate logistic regression analysis, a higher risk of xerophthalmia was observed in boys (Adjusted odd ratio [AOR]: 1.7, 95% confidence interval [CI]: 1.2-2.5) and Orang Asli (OA, indigenous) schoolchildren (AOR: 2.0, 95% CI: 1.3-3.0), while schoolchildren with overweight/obesity status (AOR: 0.5, 95% CI: 0.3-0.8) were associated with a reduced risk of xerophthalmia. The present study unveils a high prevalence of xerophthalmia among vitamin A-deficient primary schoolchildren in rural areas of Malaysia, especially among the indigenous community. The identified socio-demographic and nutritional factors associated to xerophthalmia would facilitate the implementation of more targeted interventions in addressing these issues. This cross-sectional study included 596 rural primary schoolchildren (8-12 years old) in Malaysia, diagnosed with vitamin A deficiency (VAD) and marginal VAD. Xerophthalmia prevalence was 48.8%, with conjunctival xerosis (38.9%) as the most common sign. Higher risk of xerophthalmia was seen in boys and Orang Asli (indigenous) students, while children with overweight/obesity showed reduced risk. The identified risk factors linked to xerophthalmia could aid in targeted intervention efforts. [Display omitted] [ABSTRACT FROM AUTHOR]
- Published
- 2024
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