Lakhasly

Discussion

The NNMB for the first time carried out the study in all the states of South India covering large state representative sample and this communication, for the first time reporting the prevalence of clinical and sub- clinical VAD among the rural pre-school children of South India.The proportion rural pre-school children

with clinical and sub-clinical VAD were higher in North India as compared to their counterparts in South India, where the corresponding figures of Bitot's spot and sub- clinical VAD were 0.9% and 64%, respectively."* The prevalence of Bitot's spots was lower in the present study as compared to the figures reported for rural pre- school children of Bihar (4.7%),"?,Maharashtra, (C) Madhya Pradesh (1.4%),"* eight NNMB states of India (0.8%) and central India (2.2%)."" Similarly, a higher prevalence of Bitot's spot was reported among the pre- school children of chronic drought affected states.'* While, the prevalence was comparable with figures reported for the rural pre-school children of West Bengal (0.6%)."* Similarly, a higher proportion of rural pre-school children of North India (64%),* Madhya Pradesh (88%)"*, West Bengal (61.2%) and eight NNMB states of India (61.8%) had sub-clinical VAD, while a lower prevalence of sub-clinical VAD was reported for the rural pre-school children of Maharashtra"? as compared to children in South India. Furthermore, the prevalence of VAD was significantly higher (p<0.001) 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 facility of sanitary latrine is absent. In general, we could attribute the vitamin A deficiency to prolonged deficit consumption of vitamin A rich foods and consumption of foods where the bio- availability of vitamin A is poor. This is evident from the NNMB studies carried out in different time points,'9?3! where the household and individual consumption of foods rich in vitamin A was grossly deficient as against their recommended dietary intakes (RDIs) and consequently the dietary intake of vitamin A was largely deficit as compared to the recommended dietary allowances (RDA). The NNMB survey carried out during the corresponding period reported that the proportion of rural pre-school children not meeting even 50% of their RDA for vitamin A was highest in the state of Andhra Pradesh (92.9%), followed by Kerala (91.8%), Karnataka (90.4%) and Tamil Nadu (81.9%), and the corresponding figure reported for eight NNMB states was 86.3%."We also thank Dr. Harikumar R, Dr Mallikarjuna Rao K, Galreddy CH, Sharad Kumar, Ravindranath M, Sree Ramakrishna and all the staff of Division of Community Studies for their technical help, and Mr Santosh Kumar Sahu, Miss Sarala, Mr Hanumantha Rao G and Mrs Prashanthi G for secretarial support.

Discussion

The NNMB for the first time carried out the
study in all the states of South India covering large state
representative sample and this communication, for the
first time reporting the prevalence of clinical and sub-
clinical VAD among the rural pre-school children of
South India. In general, the overall prevalence of Bitot’s
spot an objective ocular clinical sign of VAD was 0.6 %,
suggestive of VAD as public health concern among the
rural children of South India. Similarly, the magnitude of
sub-clinical VAD (59.3%) was a severe public health
problem among rural children of all the four states of
south India. The proportion rural pre-school children

with clinical and sub-clinical VAD were higher in North
India as compared to their counterparts in South India,
where the corresponding figures of Bitot’s spot and sub-
clinical VAD were 0.9% and 64%, respectively.”* The
prevalence of Bitot’s spots was lower in the present
study as compared to the figures reported for rural pre-
school children of Bihar (4.7%),”°,Maharashtra, ©
Madhya Pradesh (1.4%),"* eight NNMB states of India
(0.8%) and central India (2.2%).”” Similarly, a higher
prevalence of Bitot’s spot was reported among the pre-
school children of chronic drought affected states.’*
While, the prevalence was comparable with figures
reported for the rural pre-school children of West Bengal
(0.6%).”* Similarly, a higher proportion of rural
pre-school children of North India (64%),* Madhya
Pradesh (88%)"*, West Bengal (61.2%) and eight
NNMB states of India (61.8%) had sub-clinical VAD,
while a lower prevalence of sub-clinical VAD was
reported for the rural pre-school children of
Maharashtra"? as compared to children in South India.
Furthermore, the prevalence of VAD was significantly
higher (p