Vitamin A status of children in the urban slums of Karachi, Pakistan, assessed by clinical, dietary, and biochemical methods

We assessed the vitamin A status of 532 children with an age range of 6- 60 months who were living in slum areas of Karachi, Pakistan, using three methodologies: clinical eye examination, dietary vitamin A intake, and serum retinol level. No definite clinical signs of xerophthalmia were observed in any of these children. The mean ± SD vitamin A intake estimated from a food frequency questionnaire for the group with inadequate (low and deficient) serum retinol levels (< 20 μg/dl) was 362 ± 332 retinol equivalents (RE) compared with 431 ± 332) RE in the group with adequate serum levels (P < 0.005). Deficient serum retinol levels (< 10 μg/dl) were present in 12 children (2%); two of these had a healed corneal scar. Low serum retinol levels (10-19 μg/dl) were present in 46%, while 51% children had adequate levels (≥ 20 μg/dl). The mean ± SD serum retinol level for the inadequate (< 20 μg/dl) and adequate groups were 15.3 ± 2.8 and 26.6 ± 6.7 μg/dl, respectively. These results suggest that a significant number of children in these communities have low vitamin A levels and thus may constitute an at risk group. These results also suggest that the dietary intake method may be a simple and inexpensive screening tool for assessment of vitamin A status in communities.