Risk factors for developing mild nutritional blindness in urban Bangladesh.

Mild vitamin A deficiency may be associated with increased morbidity and mortality among children in developing countries. A community-based case-control study was performed to determine risk factors for mild ophthalmologic manifestations of vitamin A deficiency in urban Bangladeshi children. Cases were identified in children less than 14 years of age with night blindness with or without other signs of mild xerophthalmia detected in a house-to-house survey. Controls were randomly selected neighbors who lacked subjective and objective ophthalmologic evidence of vitamin A deficiency. Demographic characteristics that were independently associated with vitamin A deficiency in a logistic model included male gender, greater age (mean, 6.1 years in children with cases and 2.8 years in controls), and a greater number of children living with the family. After controlling for these demographic characteristics, poor intake of locally available vitamin A-rich foods, cessation of breast-feeding, and a recent history of protracted diarrhea remained associated with vitamin A deficiency. Maternal ignorance of prevention and control of vitamin A deficiency was also associated with increased risk. The results support programs that educate mothers to breast-feed and to provide appropriate food supplements and suggest that clinicians caring for children with chronic diarrhea should initiate vitamin A supplementation.