Resolution of Bitot's spots following mega-dose vitamin A supplementation in children between 1 and 5 years of age. Issue 7 (17th June 2013)

• Record Type: Journal Article
• Authors: Kapil, Umesh; Dwivedi, Shraddha; Sachdev, Harshpal S; Dwivedi, SN; Pandey, RM; Hirdyani, Harsha; Upadhyay, Ashish
• Is Part Of: Public health nutrition. Volume 17:Issue 7(2014)
• Page Start: 1614
• Page End: 1619
• Publication Date: 2013-06-17
• Subjects: Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980013001584
• Languages: English
• ISSNs: 1368-9800

Abstract

<abstract abstract-type="normal"> <title>Abstract</title> <sec id="abs1" sec-type="general"> <title>Objective</title> <p>The prevalence of Bitot's spots (BS) is often used to quantify vitamin A deficiency burden in India, both before and after mega-dose vitamin A supplementation (MVAS) programmes. However, the proportion of BS cured following this intervention is unclear in contemporary times. The current study evaluated the responsiveness of BS over 1 year to MVAS administered as per the national programme in rural India.</p> </sec> <sec id="abs2" sec-type="general"> <title>Design</title> <p>Prospective, community-based, 1-year follow-up of a cohort.</p> </sec> <sec id="abs3" sec-type="general"> <title>Setting</title> <p>Rural Uttar Pradesh, India.</p> </sec> <sec id="abs4" sec-type="subjects"> <title>Subjects</title> <p>Two hundred and sixty-two children with BS, aged between 1 and 5 years, administered 60 mg (retinol equivalent) of vitamin A on diagnosis and after 1 month. Cure or resolution was defined if there was no discernible BS in either eye.</p> </sec> <sec id="abs5" sec-type="results"> <title>Results</title> <p>During 1 year, only three children were lost to follow-up. At 6 months of follow-up (MVAS at baseline and 1 month later), 51·1 (95% CI 45·3, 57·3) % were classified as cured. The corresponding figure at 1 year (additional MVAS at 6 months) was 59·9 (95% CI 54·1, 65·9) %. Among those cured at 6 months, about half and three-quarters had resolved at 2 and 3 months, respectively. Apart from male gender, there were no significant sociodemographic or clinical predictors of response.</p> </sec> <sec id="abs6" sec-type="conclusion"> <title>Conclusions</title> <p>Substantial non-response to MVAS at 6 months (49%) and 1 year (40%) of follow-up suggests that presently in the Indian subcontinent, BS is a relatively crude indicator of severe current vitamin A deficiency. For programmatic decisions and evaluation, the public health burden of vitamin A deficiency should not be assessed solely through BS.</p> </sec> </abstract>