{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T20:45:33Z","timestamp":1786999533490,"version":"build-2736575974"},"reference-count":54,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2011,9,2]],"date-time":"2011-09-02T00:00:00Z","timestamp":1314921600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S136898001100214X_abs1\" sec-type=\"general\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S136898001100214X_abs2\" sec-type=\"general\">\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S136898001100214X_abs3\" sec-type=\"general\">\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Rural areas of eight states in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S136898001100214X_abs4\" sec-type=\"subjects\">\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>Pre-school children and their mothers were covered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S136898001100214X_abs5\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0\u00b78 %. The total ocular signs were significantly higher (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0\u00b7001) among boys (2\u00b76 %) compared with girls (1\u00b79 %) and in older children (3\u20134 years) compared (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0\u00b7001) with younger (1\u20132 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR = 3\u00b78; 95 % CI 2\u00b79, 5\u00b70), labourers (OR = 2\u00b79; 95 % CI 2\u00b71, 3\u00b79), illiterate mothers (OR = 2\u00b77; 95 % CI 2\u00b72, 2\u00b73) and households without a sanitary latrine (OR = 5\u00b79; 95 % CI 4\u00b70, 8\u00b77). Subclinical VAD (serum retinol level &lt;20 \u03bcg\/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S136898001100214X_abs6\" sec-type=\"conclusion\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s136898001100214x","type":"journal-article","created":{"date-parts":[[2011,9,2]],"date-time":"2011-09-02T04:47:26Z","timestamp":1314938846000},"page":"568-577","source":"Crossref","is-referenced-by-count":37,"title":["Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India"],"prefix":"10.1017","volume":"15","author":[{"given":"Avula","family":"Laxmaiah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhavan K","family":"Nair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimmathota","family":"Arlappa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pullakhandam","family":"Raghu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagalla","family":"Balakrishna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kodavanti","family":"Mallikharjuna Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chitty","family":"Galreddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharad","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manachala","family":"Ravindranath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varaganti","family":"Vikas Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginnela NV","family":"Brahmam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2011,9,2]]},"reference":[{"key":"S136898001100214X_ref27","volume-title":"54th Round of Consumer Expenditure Survey","year":"1998"},{"key":"S136898001100214X_ref53","doi-asserted-by":"publisher","DOI":"10.1301\/00296640260130786"},{"key":"S136898001100214X_ref43","volume-title":"Order no. 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UNICEF & The Micronutrient Initiative (2005) Vitamin A and Mineral Deficiency: A Global Progress Report, p. 4. http:\/\/www.micronutrient.org\/CMFiles\/PubLib\/Report-67-VMD-A-Global-Damage-Assessment-Report1KSB-3242008-9634.pdf (accessed November 2010)."},{"key":"S136898001100214X_ref14","volume-title":"Global Prevalence of Vitamin A Deficiency. WHO Working Paper","year":"2002"},{"key":"S136898001100214X_ref15","volume-title":"Global Prevalence of Vitamin A Deficiency (1995\u20132005)","year":"2009"},{"key":"S136898001100214X_ref19","unstructured":"19. National Nutrition Monitoring Bureau (2000) Dynamic Database on Diet and Nutrition. 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