For the present study, a total of 35,480 (Boys: 
18,216; Girls: 17,264) rural children of 1-5 year age 
group was covered from four South Indian States of 
India.The prevalence of Bitot's spot, an objective 
ocular clinical sign of VAD was significantly higher 
among the rural children of socio-economically 
marginalized sections of the communities such as 
Scheduled Caste (SC) & Scheduled Tribe (ST), labourers, 
illiterate mothers and those residing in the households 
where the sanitary latrine is absent (p=20%,
23 suggestive of severe public health 
problem and it ranged from a low 48.8% in the state of 
Tamil Nadu to a high 79.4% in Kerala (Table 2).The prevalence of sub-clinical vitamin A deficiency among 
the rural children (59.3%) was more than the WHO cutoff of 20%, indicating VAD as a severe public health 
problem among all the age groups, and the prevalence 
increased significantly (p