Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 92466

AbstractMaterial and MethodsResultsDiscussionKey MessageAcknowledgementReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2011 | Month : December | Volume : 5 | Issue : 8 | Page : 1627 - 1630 Full Version

Prevalence of Clinical Vitamin A Deficiency Among Primary School Children in Urban Slums of Ahmedabad: A Cross Sectional Study


Published: December 1, 2011 | DOI: https://doi.org/10.7860/JCDR/2011/.1796
Naresh T. Chauhan, Trivedi Atul V., Khan Iqbal M., Talsania Niti J.

1. Assistant Professor, Community Medicine Department, Government Medical College, Bhavnagar, India 2. Assistant Professor, Community Medicine Department, B. J. Medical College, Ahmedabad, India 3. Assistant professor, Deptt. of community medicine, Geetanjali medical college & Hospital Manwa Kheda, NH-8 Byepass Udaipur, Rajasthan 4. Professor, Community Medicine Department, B. J. Medical College, Ahmedabad, India.

Correspondence Address :
Naresh T. Chauhan,
Flat No 1, Shivganga Flats, Oppo. Bavlia Hanuman Temple,
Bhayanini wadi, Bhavnagar, Gujarat, India - 364003.
Phone: +919904266004; Fax: +912782431866
E-mail - drnareshchauhan@rediffmail.com.

Abstract

Background: Although there is a substantial documentation of prevalence, severity and health consequences of vitamin A deficiency (VAD) in preschool-aged children, very few studies have been done to find out the extent of VAD in primary school children. Present study was carried out in school children (5-15 years age) from slum areas of Ahmedabad city to see the prevalence of xerophthalmia.

Aims: To clinically asses the prevalence of xerophthalmia among school going children in urban slums of Ahmedabad. To study the socio-demographic factors associated with VAD in urban slums.

Settings and Design: The present study was designed as a cross sectional study conducted in primary schools of urban slums in Ahmedabad from October 2007 to July 2008. Methods and Materials: 1000 children were randomly selected from 10 schools and examined with predesigned and pretested Performa. From each school 100 children were randomly selected from standard I-VII. Xerophthalmia was diagnosed if there was a history of night blindness, or on examination, there were signs of conjunctival xerosis, Bitot’s spots, corneal xerosis or keratomalacia.

Statistical Analysis: The collected information was analysed by using the Microsoft Excel and the Epi info 3.4 software. Chisquare test was used for analysis.

Results: In this study prevalence of VAD was found to be 2.9%. Prevalence of VAD among girls (4.1%) was significantly high than boys (1.9%). In present study 0.5% cases of night blindness, 1.4% cases of conjunctival xerosis and 2.1% cases of Bitot’s spot were found. Types of family, lower social class (class IV & V) and poor intakes of green vegetables were significantly associated with the vitamin A deficiency.

Conclusion: The observation of this study underlines the magnitude and severity of vitamin A deficiency in an age group that policy makers do not usually consider to be at risk in this respect.

Keywords

Ahmedabad, Vitamin A deficiency, Xerophthalmia, Night blindness, Bitot’s spot

Introduction
Deficiency of vitamin A has long been identified as a serious and preventable nutritional disease. It also contributes significantly, even at sub-clinical levels, to morbidity and mortality from common childhood infection. Studies suggest that ill health and risk of death from some infection are also increased even in children who are not clinically deficient but, whose vitamin A body stores is depleted (1),(2). Though one of the main causes of xerophthalmia is poor intake of vitamin A rich foods, it is also associated with poverty, ignorance, faulty feeding habits among the entire population but young children in particular (3). At least 45 countries are now known to have serious vitamin A deficiency (VAD) (3),(4). Corneal scarring results from deficiency of vitamin A is responsible for about 19% of all causes of childhood blindness (5).

Surveys indicate that the intake of Vitamin A is, on an average, about half the recommended dietary intake. It is important that the dietary practices are improved and intake of Vitamin A rich foods be actively promoted. The diet and nutritional status of urban slumchildren in India is far away from being satisfactory. Lack of basic amenities like safe drinking water, proper housing, drainage and excreta disposal make this population more vulnerable to infection which further compromise the nutrition of those living in the slums. Children living in slum are more prone to nutritional deficiency disorders (6).

Present study was a small effort to assess the prevalence of VAD among school children of 5-15 years in urban slums of Ahmedabad, India.

Material and Methods

Selection of study population &sample size: A cross sectional study was conducted among primary school children in the age group 5-15 years. The study was conducted from October 2007 to July 2008. Total sample size was calculated of 1000 children considering 30 % prevalence of ocular morbidity in the pilot study. Sample size of 933.33 was calculated by considering 30% prevalence of ocular morbidity in the pilot study with the help ofSelection of study population &sample size: A cross sectional study was conducted among primary school children in the age group 5-15 years. The study was conducted from October 2007 to July 2008. Total sample size was calculated of 1000 children considering 30 % prevalence of ocular morbidity in the pilot study. Sample size of 933.33 was calculated by considering 30% prevalence of ocular morbidity in the pilot study with the help offormula 4pq/l2 where (l= 10% of p). For practical reason and feasibility of survey, sample size of 1000 was decided for the study.

Sampling Method:
Population of Ahmedabad city was 35, 20, 850 distributed in five zones (Census 2001). List of primary schools running in slums in each zone was obtained from Ahmedabad Municipal Corporation. From 531 schools, 10 schools were selected by the simple random sampling method. Two schools selected from each zone and 100 children from each school were examined to achieve desired sample size. First standard wise cumulative frequency was prepared according to roll no and class interval was calculated for the selection of 100 children proportionate representation from each class.

Training and Survey technique:
Training for identification of various stages of vitamin A deficiency (xerophthalmia) was conducted at a local institute. Prior permission for the study was taken from the school authorities. The investigator filled a predesigned and pretested proforma after explaining the purpose of the study. The first child was selected randomly by lottery method. If selected child was absent, next child was selected. The questionnaire dealt with information regarding the child like age, sex, residential address, class in which the student is studying, education, occupation and income of parents and dietary intake of dark green leafy vegetables/yellowish fruits. All the children were examined in day light for vitamin A deficiency. Xerophthalmia was diagnosed if there was history of night blindness, or there were signs of conjunctival xerosis, Bitot’s spots, corneal xerosis and keratomalacia on clinical examination (7). Anthropometric measurements were recorded as per the standard WHO guidelines. Dietary intake of dark green leafy vegetables/yellowish fruits noted in terms of frequency of consumption per week (1). BMI percentiles were calculated for each respective age group. The BMI percentile between the 5th percentile to less than the 85th percentile was taken as normal, the 85th to less than the 95th percentile was taken as overweight and that which was equal to or above the 95th percentile was taken as obese. Socio-economic classification of children was done by modified Prasad classification method. Children diagnosed having xerophthalmia were given two lakh IU of vitamin A solution on the spot and referred to local health institute.

Data analysis:
All the data were analyzed by Epi-info 3.4.3. The chisquare test was used to test difference in proportions. Differences were considered statistically significant at 5% level.

Results

Observation and results
The present study was conducted among primary school children aged 5-15 years in urban slums of Ahmedabad. In total, 1000 examined including 53.6% boys and 46.4% girls (Table/Fig 1). All the children examined were from age 5-15 years of age and mean age was 9 years. Among study participants, 88.6% belong to nuclear family and 45% had more than three siblings. 34.8% father and 34.8% mother were illiterate. Majority of children had their both parents (82.5%) working as unskilled/semi-skilled/skilled work. As per modified Prasad classification, 36.5% family belongs to lower (IV &V) social class. Body mass index was measured and 73.3% children found underweight and 16.6% overweight/obese.

(Table/Fig 2) shows age and sex wise distribution of VAD. Highest no of cases observed in age group 9 to 10 yrs (5.9%) and lowest in age group 13 to 14 years (0.8%). Higher prevalence in girls was statistically significant (p=0.03) but no significant association between age and VAD (p=0.11). (Table/Fig 3) shows various manifestation of vitamin A deficiency. Almost 3% of boys and girlsreported VAD in various forms of xerophthalmia. As per WHO standards of prevalence of night blindness >1% and Bitot’s spot, >0.5% considered as public health problem among preschool and school children. The prevalence of night blindness 0.5%, Bitot’s spot 2.1% and of conjunctival xerosis 1.4% was found in present study (Table/Fig 3).

Various factors like type of family-nuclear or joint, number of siblings, paternal education, maternal education, parent’s occupational status-weather both parents working or father only working, social class as upper and middle(I,II &III) or lower (IV &V), nutritional status-normal weight or malnourished (underweight, overweight, or obese), and consumption of dark green leafy vegetables wereassessed to determine any association with VAD among school children (Table/Fig 4).

Occurrence of VAD was significantly high among children residing in joint family than nuclear family (p=0.00). No statistical significance was found for children having number of sibling three or more than three (p=0.06). Similarly, no association was found between education status of father (p=0.23) and mother (p=0.90) and occurrence of VAD. No association was found for parents working status and VAD (p=0.07). Significant number of cases of VAD reported among lower socio-economic children (class IV & V)(p=0.00). Nutritional status of children was not found to be associated (p=0.45) with occurrence of VAD but the consumption of dark green leafy vegetables < 3times per week significantly associated with occurrence of VAD (p=0.01).

Discussion

Although there is a substantial documentation of prevalence, severity and health consequences of vitamin A deficiency in preschool-aged children, extent of VAD in older children has not given much attention. Present study was carried out in primary school children (5-15 years age) from slum areas of Ahmedabad city to see the prevalence of VAD.

In present study prevalence of vitamin A deficiency was observed to be 2.9% which was similar to finding of a comprehensive study of morbidity in Tamilnadu (8). Cross-sectional survey with multistage sampling of 3 of 19 districts (Baroda, Ahmedabad and Rajkot) in Gujarat state showed 6.30 % to 13.5 % prevalence in same age group (9). Studies done on school children in other part of country show prevalence of xerophthalmia ranging from 1.8 % to 10.6% (10),(11),12],(13),(14). Evidence from various countries of South-eastern Asia had shown VAD ranging from 0.2 % to 15 % in school aged children (15). In present study, highest no of cases were observed in age group 9 to 10 years (5.9%) and lowest in age group 13 to 14 years (0.8%). The prevalence of xerophthalmia among boys was 1.9% and in girls it was 4.1% and the difference observed was statistically significant, p=0.03. These observations were correlated with the Ethiopian study conducted by Tarik Kassaaye et al. (16), but not to the Lucknow study conducted by D. Kumar et al (10). The prevalence of night blindness (0.5%) in the present study comparable to the Gupta et al., study (14). Wedner et al., reported the higher prevalence (5.3%) of night blindness among school children (7-19years) but the study conducted in rural area of Tanzania (17). Prevalence of vitamin A deficiency was higher in social class IV and V, than in social class I, II and III. This difference was statistically significant, p=0.00. Similar observation was found in the study done by Pal R et al (18).

Dietary deficiency of vitamin A leads to development of xerophthalmia in those children taking insufficient green leafy vegetables. This was also observed by Tarik Kassaaye et al and Faruk Ahmed et al (16),(19).

This study suffers from two limitation, first is that we included children who were present at the time of data collection, if the selected child was absent next child selected. This could have an effect on prevalence of VAD. Second was we had collected the data regarding consumption of green leafy vegetables but not about other rich sources of vitamin A which could be significantly associated with prevalence of xerophthalmia.

The observation of this study underlines the magnitude and severity of vitamin A deficiency in an age group that policy makers do not usually consider to be at risk in this respect. It is important to educate the community about the important morbidity in school age children, their aetiology and prevention. Provision of rich food in vitamin A must be supplied regularly in Mid Day Meal. Increase awareness of school children and parents about importance of taking dark green leafy vegetables, yellow fruits and dairy products by respective Public Health people in the district. Identify highrisk children who are prone to develop vitamin A deficiency and intervene with appropriate strategy to prevent xerophthalmia amongst those children. If space is available than school kitchengarden should be made, So that children can take message to their home to develop kitchen garden.

Vitamin A deficiency observed among children less than five years of age group in urban slums range from 5.3 % to 24.6 %. However, data on the 5 to 15 years age group not readily available for this under privileged group (20). Efforts to reduce vitamin A deficiency in younger children to a level is not considered to be of public health significance which are encouraging but challenging the task remains in children 5-15 year age in which prevalence is high (15). Further studies are required to map out the prevalence of vitamin A deficiency among 5 to 15 years age group in urban slum in other part of India, so that attention of the policy maker to this problem can be drawn.

Key Message

Prevalence of vitamin A deficiency in older children (5-15 years) is high and it demands systemic evaluation of the extent of VAD in this age group.

Acknowledgement

We acknowledge all the Principals of primary schools and their staff for helping us in conducting this study. We are also thank full to Dr. V. S. Rawal, then professor and head of Community Medicine Deptt, B.J. Medical College, Ahmedabad for his support.

References

1.
WHO. Indicators for assessing vitamin A deficiency and their application in monitoring and evaluating intervention programmes. WHO/ NUT/96.10 Geneva. WHO.1996.
2.
WHO. Vitamin Deficiency and Xerophthalmia. Report of a joint WHO/ USAID Meeting Geneva. WHO.1974 Technical Report Series:590.
3.
WHO. Global prevalence of vitamin A deficiency in population at risk 1995-2005 [Internet]. 2009 [cited 2011 June 6], available from: http:// www.who.int/vmnis/vitamina/prevalence/report/en/
4.
WHO. Prevention and Control of Vitamin A Deficiency, Xerophthalmia and Nutritional Blindness. Proposal For a Ten-Year Programme of Support to Countries. WHO/NUT/85.6. Geneva. WHO. 1985.
5.
Foster A. Childhood blindness in India and Sri Lanka. Indian J Ophthalmol [serial online] 1996 [cited 2011 Jun 4];44:57-60. Available from: http://www.ijo.in/text.asp?1996/44/1/57/24610
6.
Ghosh S, Shah D. Nutritional problems in urban slums. Indian Pediatrics 2004;41:682-95.
7.
WHO. Control of Vitamin A Deficiency and Xerophthalmia, Report of a Joint WHO/UNICEF/USAID/Helen Keller International/IVACG Metting, Geneva. WHO. 1982. Technical Report Series: 672.
8.
Ananthakrishnan S, Pani SP, Nalini P. A Comprehensive Study of Morbidity in School Age Children. Indian Pediatrics 2001; 38: 1009-17.
9.
World Health Organization. WHO Global Database on Vitamin A Deficiency, Vitamins and Minerals Nutrition Information System (VMNIS), [Internet]. 2007 [cited 2009 April 16], available from: available at http://who.int/vmnis/vitamina/data/database/countries/ind_vita.pdf.
10.
Kumar D, Singh JV, Ahuja PC, Agarwal J, Mohan U. Occular morbidity among school children in Sarojini nagar development block of Lucknow. Indian J of Community Med 1992;18:109-13.
11.
Awate RV, Ketkar YA, Somaiya PA. Prevalence of nutritional deficeincy disorders among rural primary school children (5-15 years). J Indian Med Assoc 1997;95:410-15.
12.
Chaturvedi S, Aggarwal OP. Pattern and distribution of ocular morbidity in primary school children of rural Delhi. Asia Pac J Public Health 1999;11:30-33.
13.
Nepal BP, Koirala S, Adhikary S, Sharma AK. Ocular morbidity in school children in Kathmandu. Br. J. Ophthalmol 2003;87:531-34.
14.
Gupta Madhu, Gupta Bhupinder P, Chauhan Anil, Bhardwaj Ashok. Ocular morbidity prevalence among school children in Shimla, Himachal, North India. Indian J Ophthalmol 2009;57:133-38.
15.
Singh V, West KP Jr. Vitamin A deficiency and xerophthalmia among school-aged children in Southeastern Asia. Europian Journal of Clinical Nutrition 2004;58:1342-49.
16.
Kassaye T, Receveur O, Johns T, Becklake MR. Prevalence of vitamin A deficiency in childern aged 6-9 years in Wukro,northen Ethiopia. Bulletin of the World Health Organization, WHO, Geneva 2001;79: 415-22.
17.
Wedner SH, Ross DA, Balira R, Kaji L, Foster A. Prevalence of eye diseases in primary school children in a rural area of Tanzania. Br J Ophthalmol 2000;84:1291-7.
18.
Pal R, Sagar V. Antecedent risk factors of xerophthalmia among Indian rural preschool children. Eye Contact Lens 2008;34:106-8.
19.
Faruk A, Ataur R, Adeba NN, Mohammad A. Anaemia and vitamin A status among adolescent schoolboys, Public Health Nutrition 2005;9:345–50.
20.
Awasthi S, Agarwal S. Determinants of childhood Mortality and Morbidity in Urban Slums in India, Indian Paediatrics 2003;40:1145-61.

DOI and Others

JCDR/2011/1796

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com