Abrha Tesfalem, Girma Yonas, Haile Kebede, Hailu Mezgebe, Hailemariam Mengistu
Department of Medicine, Aksum University, Aksum, Ethiopia.
Department of Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran ; Center of International Reproductive Health Training (CIRHT), Bahir Dar University, Bahir Dar, Ethiopia.
Arch Public Health. 2016 Mar 14;74:4. doi: 10.1186/s13690-016-0122-3. eCollection 2016.
Vitamin A Deficiency is a common form of micronutrient deficiency, globally affecting 33.3 % of preschool-age children. An estimated of 44.4 % of preschool children in Africa were at risk for vitamin A deficiency. In Ethiopia, vitamin A deficiency leads to 80,000 deaths a year and affects 61 % of preschool children. The aim of this study was to investigate the prevalence and associated factors with the night blindness, Bitot's spot and vitamin A intake among preschool children in rural area, Asgede-Tsimbla district, North Ethiopia.
Community based cross sectional study was conducted from January 27 to March 7, 2014. A total 1230 preschool children were selected by systematic random sampling from 8 randomly selected kebelles (smallest administrative unit). Structured and pretested questionnaires adapted from relevant studies and WHO/FAO was for data collection. In addition, sex, age, and height were taken and filled to Emergency Nutrition Assessment (ENA) for Standardized Monitoring and Assessment of Relief and Transition (SMART) 2007 software to convert the nutritional data into Z-scores of the indices. The data was then transported to SPSS version 20. Bivariate and Multivariable binary logistic regressions were carried out to investigate the effect of each independent variable on the dependent variable. Statistical significance was set at p-value < 0.05.
The odds of Bitot's spots (1.46 %) and night blindness (1.22 %) were higher than the WHO Cut-off levels used to define a public health problem. The odds of night blindness was 4 times higher among children belonging to family size greater or equal to four [Adjusted Odds Ratio (AOR) = 4.18, 95 % CI = 1.15,15.3] and 6 times higher among children of illiterate mothers [AOR = 5.96 , 95 % CI = 1.33,26.69]. The odds of Bitot's spots was 5.35 times higher among children belonging to family size greater or more four [AOR =5.35; 95 % CI = 1.49, 19.2], 4.75 times higher among children of illiterate mothers [AOR = 4.75, 95 % CI =1.32, 17.18] and 6 times higher in males than females [AOR = 5.8, 95 % CI = 1.65, 20.46].
The study revealed that night blindness and Bitot's spots are major nutritional problems in the study area. The independent predictors of night blindness were mother illiteracy status and large family size and also for Bitot's spots were mother illiteracy status, male sex of child and large family size. Therefore, the need to increase educational level of mother, use of family planning of women and emphasis on male children and children from large family size by involving the Education sector, Health sector, (Federal Ministry of Health) FMOH and (Tigray Regional Health Bureau) TRHB is crucial.
维生素A缺乏是一种常见的微量营养素缺乏形式，全球有33.3%的学龄前儿童受其影响。据估计，非洲44.4%的学龄前儿童有维生素A缺乏风险。在埃塞俄比亚，维生素A缺乏每年导致8万人死亡，影响61%的学龄前儿童。本研究的目的是调查埃塞俄比亚北部阿斯盖德-辛布拉区农村地区学龄前儿童夜盲症、毕脱斑和维生素A摄入量的患病率及相关因素。
2014年1月27日至3月7日进行了基于社区的横断面研究。通过系统随机抽样从8个随机选取的凯贝勒（最小行政单位）中选取了1230名学龄前儿童。采用从相关研究及世界卫生组织/联合国粮食及农业组织改编而来的结构化且经过预测试的问卷进行数据收集。此外，记录性别、年龄和身高，并录入《紧急营养评估》，用于2007年《救济与过渡标准化监测与评估》（SMART）软件，将营养数据转换为各指标的Z分数。然后将数据传输至SPSS 20版。进行二元和多变量二元逻辑回归，以研究每个自变量对因变量的影响。设定p值<0.05为具有统计学意义。
毕脱斑（1.46%）和夜盲症（1.22%）的患病率高于世界卫生组织用于定义公共卫生问题所采用的临界水平。家庭规模大于或等于4口人的儿童患夜盲症的几率高出4倍[调整优势比（AOR）=4.18，95%置信区间（CI）=1.15，15.3]，母亲为文盲的儿童患夜盲症的几率高出6倍[AOR=5.96，95%CI=1.33，26.69]。家庭规模大于或等于4口人的儿童出现毕脱斑的几率高出5.35倍[AOR=5.35；95%CI=（1.49，19.2）]，母亲为文盲的儿童出现毕脱斑的几率高出4.75倍[AOR=4.75，95%CI=1.32，17.18]，男性儿童出现毕脱斑的几率比女性高出6倍[AOR=5.8，95%CI=1.65，20.46]。
研究表明，夜盲症和毕脱斑是研究地区主要的营养问题。夜盲症的独立预测因素是母亲的文盲状况和家庭规模大，毕脱斑的独立预测因素是母亲的文盲状况、儿童的男性性别和家庭规模大。因此，通过教育部门、卫生部门（联邦卫生部）和提格雷地区卫生局（TRHB）提高母亲的教育水平、推行妇女计划生育并关注男性儿童和大家庭儿童至关重要。
