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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.