Vitamin A Status of Children in the Urban Slums of Karachi, Pakistan, Assessed by Clinical, Dietary, and Biochemical Methods

Ayesha Molla Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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Salma H. Badruddin Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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Mohammed Khurshid Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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Abdul M. Molla Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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Falak N. Rahaman Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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Sahana Durrani Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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Amin Suria Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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John D. Snyder Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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Kristy Hendricks Departments of Pathology, Medicine, Paediatrics, Community Health Science, and Pharmacology, The Aga Khan University Medical Centre, The Combined Program in Pediatric Gastroenterology and Nutrition, Harvard Medical School and Applied Diarrheal Disease Research Project, Harvard Institute for International Development, Karachi, Pakistan

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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.

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