Lin Liangming, Liu Yulin, Ma Guanfu, Tan Zangwen, Zhang Xinli, Jiang Jingxiong, Song Xiaofang, Wang Li, Zhang Jianna, Wang Heru, Li Mei
Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2002 Sep;36(5):315-9.
To understand the prevalence and spatial distribution of vitamin A deficiency (VAD) in China among children at ages under six years.
About 8,600 children under 6 years of age in 14 cities and 28 counties of 14 provinces were selected with stratified cluster sampling for survey, including interview with questionnaire for their family information and nutritional status. Blood specimens were collected for measuring serum level of VA with fluorescent spectrophotometry in laboratory.
Totally, 8,669 children under 6 (2,877 in urban area and 5,792 in rural area) were surveyed in 14 provinces, with 4,629 males and 4,040 females. Eight cases of night blindness and seven cases of xerophthalmia were found among the children at ages of two to five years. Sixty-one mothers of the children in this group were also found suffering from night blindness. All the cases of night blindness and xerophthalmia both in children and mothers were living in rural areas. Based on their serum levels of VA, 11.7% of the all 1 018 children were diagnosed as VAD, with serum VA concentrations below or equal to 0.70 micro mol/L. Prevalence of VAD was 15.0% and 5.8% in rural (23.3% in the poverty-stricken counties) and urban areas, respectively, and 5.8%, 11.5% and 16.8% in the coastal, inland and remote areas, respectively. The average serum level of VA was 1.20 micro mol/L and 0.99 micro mol/L for urban and rural areas, respectively, with a national average of 1.06 micro mol/L. And, babies under six months of age with an average serum levels of VA < or = 0.70 micro mol/L accounted for 33.4%, and those at ages of four to five years with the same level of VA accounted for 8%. There was significant difference in serum levels of VA between ages, but no significant difference between genders.
VAD did exist in children of China, especially in the remote and poverty-stricken rural areas and VA supplementation is urgently needed for the children in these regions.
了解中国6岁以下儿童维生素A缺乏症(VAD)的患病率及空间分布情况。
采用分层整群抽样方法,在14个省的14个城市和28个县选取约8600名6岁以下儿童进行调查,包括通过问卷调查了解其家庭信息和营养状况。采集血样,在实验室用荧光分光光度法测定血清维生素A水平。
14个省共调查了8669名6岁以下儿童(城市地区2877名,农村地区5792名),其中男性4629名,女性4040名。在2至5岁儿童中发现8例夜盲症和7例干眼症。该组儿童的61名母亲也患有夜盲症。儿童和母亲中的所有夜盲症和干眼症病例均生活在农村地区。根据血清维生素A水平,在全部1018名儿童中,11.7%被诊断为维生素A缺乏症,血清维生素A浓度低于或等于0.70微摩尔/升。维生素A缺乏症的患病率在农村地区为15.0%(贫困县为23.3%),城市地区为5.8%,沿海、内陆和偏远地区分别为5.8%、11.5%和16.8%。城市和农村地区的血清维生素A平均水平分别为1.20微摩尔/升和0.99微摩尔/升,全国平均水平为1.06微摩尔/升。6个月以下婴儿血清维生素A水平<或=0.70微摩尔/升的占33.4%,4至5岁儿童中该水平的占8%。血清维生素A水平在年龄之间存在显著差异,但性别之间无显著差异。
中国儿童中确实存在维生素A缺乏症,尤其是在偏远和贫困农村地区,这些地区的儿童迫切需要补充维生素A。