Xerophthalmia in urban Bangladesh. Implications for vitamin A deficiency preventive strategies.

Eight per cent of children attending a nutrition unit in urban Bangladesh had the eye signs and symptoms of vitamin A deficiency. About 1 in 10 of children with xerophthalmia and moderate-to-severe protein-energy malnutrition (PEM) had corneal involvement (X2,X3A/B): seasonal variation in prevalence was striking. Xerophthalmia was commonest in the 2-3 years age group and was associated with gastro-enteritis and measles. Breast feeding rates were low for PEM children with or without xerophthalmia. Poverty and overall shortage of food are the common denominators for both PEM and xerophthalmia. Effective vitamin A deficiency preventive strategies in urban Bangladesh will need, therefore, to include a broad range of measures such as the present limited distribution of high potency vitamin A capsules (200 000 IU) to children aged 0-6 years, food subsidies and food fortification if the most vulnerable children in the slums are to be reached.