Ocular manifestation of vitamin A deficiency among Orang Asli (Aborigine) children in Malaysia

Ngah, Nor Fariza; Moktar, Norhayati; Isa, Noor Hayati Mohd; Selvaraj, Sudhakar; Yusof, Shahrom; Sani, Halimah Abdullah; Hasan, Zainal A.A.; Kadir, Rohani A.

doi:10.1046/j.1440-6047.2002.00268.x

Cited by 15 publications

(7 citation statements)

References 15 publications

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“…[24] However, a study by Ngah et al , conducted on children for ocular manifestations of vitamin A deficiency, revealed that night blindness was present in overall 16% of the children, conjunctival xerosis in 57%, Bitot's spots in 3%, corneal xerosis in 0.5%, and corneal scar in 6%; and overall 82% of the children had eye manifestation of vitamin A deficiency. [25] This study shows that night blindness was significantly associated with low RBP levels. There was a 100% sensitivity of low serum RBP levels and the diagnosis of ocular manifestations; however, four patients with normal RBP levels had ocular manifestations.…”

Section: Discussionmentioning

confidence: 85%

Serum retinol binding protein as an indicator of vitamin A status in cirrhotic patients with night blindness

Mahmood

Samo

Jairamani

et al. 2008

Saudi J Gastroenterol

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Background/Aim:Vitamin A deficiency is known to be associated with night blindness. Plasma retinol binding protein (RBP) estimation highly correlates with plasma retinol concentration to predict vitamin A status. Serum RBP estimation is reasonably simple, inexpensive, and highly applicable in less technologically developed settings. We studied the correlation of plasma vitamin A levels (by RBP estimation) and ocular manifestation in patients with liver cirrhosis.Materials and Methods:This prospective, cohort study included 137 patients with liver cirrhosis. Ocular manifestations in these patients were recorded along with detailed history and clinical examination. Blood samples after overnight fasting were measured for RBP levels. The characteristics of cirrhotic patients with and without eye findings were compared.Results:Out of 137 patients, 55% were males. The causes of cirrhosis were hepatitis C virus in 61%, hepatitis B virus in 32%, alcoholics in 3%, and primary biliary cirrhosis in 3%. Ocular manifestations were found in 47% patients. RBP levels were found to be low in 44%, normal in 40%, and relatively high in 16% patients. Low levels of RBP compared to normal were associated with opthalmological findings of hypovitaminosis A (P < 0.001).Conclusion:The measurement of plasma RBP as an alternative to serum retinol estimation to detect relative hypovitaminosis A is simple, easy and reliable. Vitamin A level is strongly related to the severity of liver disease. Opthalmological manifestations in patients with liver cirrhosis may be preventable by early detection of hypovitaminosis A with serum RBP level, but larger studies are required before recommendation of vitamin A supplementation.

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Section: Discussionmentioning

confidence: 85%

Serum retinol binding protein as an indicator of vitamin A status in cirrhotic patients with night blindness

Mahmood

Samo

Jairamani

et al. 2008

Saudi J Gastroenterol

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“…These findings were consistent with those of previous local studies conducted among Aboriginal children. 16,26 In comparison with the neighboring countries in Southeast Asia, a higher prevalence of VAD (serum retinol concentration < 0.70 μmol/L) was reported among children in rural regions of southern Vietnam and along the southern coast of central Java in Indonesia. 10,27 During the 1990s, Indonesia showed good progress in reducing VAD but the prevalence of the transition changed after the tsunami disaster of 2004 that killed more than 200,000 persons in the territories of Ache, Nias, and Sumatra.…”

Section: Discussionmentioning

confidence: 99%

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Al-Mekhlafi¹,

Surin²,

Sallam³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract.A cross-sectional study was carried out on 241 primary schoolchildren in Pahang, Malaysia to update their vitamin A status and to investigate the association of poor vitamin A status with their health and socioeconomic factors. All children were screened for intestinal parasitic infections. Blood samples were collected and vitamin A status was assessed. Socioeconomic data were collected by using pre-tested questionnaires. The results showed that 66 (27.4%) children had low serum retinol levels (< 0.70 μmol/L). Giardiasis and severe ascariasis were significantly associated with low serum retinol levels ( P = 0.004 and P = 0.018, respectively). Logistic regression confirmed the significant association of giardiasis with low serum retinol (odds ratio = 2.7, 95% confidence interval = 1.3-5.5). In conclusion, vitamin A deficiency is still a public health problem in rural Malaysia. Vitamin A supplementation and treatment of intestinal parasitic infections should be distributed periodically to these children to improve their health and nutritional status. 18 Iintensity of infection was graded as heavy, moderate, or light according to criteria proposed by the World Health Organization.19 Scores for intensity of infections were given to each soil-transmitted helminth species (light = 1, mild = 2, and severe = 3) and mixed infections with a worm score ≥ 5 were included in the analysis. Samples were also examined for Giardia duodenalis trophozoites or cysts by using the trichrome staining technique.Assessment of vitamin A status. Approximately 2-3 mL of venous blood were collected from each participant into tubes for biochemical analysis. Blood was left at room temperature to ensure clot formation. The tubes were then centrifuged at 3,000 rpm for 10 minutes to obtain serum that was stored at -20°C until further analysis. Serum retinol concentrations were determined using a reverse-phase high performance liquid chromatography (LC-10AD; Shimadzu, Kyoto, Japan) as described. 16,20 One hundred microliters of ethanol containing retinyl acetate as an internal standard was added to 100 μL of serum. Refiltered petroleum ether (RPE) (500 μL) was added and the mixture was mixed with a vortex mixer for 1 minute and centrifuged at 5,000 rpm for 10 minutes. A 150-μL sample from the refiltered petroleum ether layer was transferred into a clean test tube and evaporated. The extract was dissolved in 200 μL of ethanol. Eighty microliters of this mixture was injected into the high performance liquid chromatography apparatus. Methanol:water (95:5 [v/v]) was used as the mobile phase and all-trans retinol was used as the standard. For quality control, 20% of the samples were randomly selected and examined in duplicate. Serum retinol was measured in picomoles per liter.Use of serum retinol to assess vitamin A status may be influenced by inflammation and reductions in plasma retinol, which have been described during the acute phase of a wide range of infections. 21 The design of this study did not consider the inflammatory status of the...

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“…When serum retinol concentrations fall below 1.0 µmol/L, impaired adaptation to the dark can begin, although it is more common when they fall below 0.7 µmol/L [ 4 ]. Many studies have employed a history of night blindness given by parents as part of the method for assessing the prevalence of this condition [ 18 , 19 ]. Both our patients were intellectually disabled, which hinders the ability of parents to notice the sign.…”

Section: Discussionmentioning

confidence: 99%

Xerophthalmia in Picky Eater Children

Ifwat¹,

Liew²,

Hamid³

et al. 2022

Cureus

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Xeropthalmia refers to a range of ocular symptoms caused by vitamin A deficiency (VAD), ranging from night blindness and Bitot's spots to corneal xerosis, ulceration, and keratomalacia, which can lead to blindness. We report two cases of xerophthalmia in children with intellectual disabilities. Ocular examination revealed generalized conjunctival xerosis, corneal xerosis, and dense superficial punctate keratopathy. Both share a history of a strict self-selective diet of mainly rice and noodles. Serum vitamin A levels for these children showed a very low level (<0.10 µmol/L) and were categorized as severe VAD. One of the cases showed signs of improvement, and the other one succumbed to death secondary to pneumonia. Therefore, proper historytaking, early detection, and prompt treatment are important to prevent the devastating sequelae of VAD.

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Ocular manifestation of vitamin A deficiency among Orang Asli (Aborigine) children in Malaysia

Cited by 15 publications

References 15 publications

Serum retinol binding protein as an indicator of vitamin A status in cirrhotic patients with night blindness

Serum retinol binding protein as an indicator of vitamin A status in cirrhotic patients with night blindness

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

Xerophthalmia in Picky Eater Children

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