Prevalence of Vitamin A Deficiency among Preschool Children in Ethiopia: A Systematic Review and Meta-Analysis

Zekariyas Sahile; Delelegn Yilma; Robel Tezera; Tadu Bezu; Werissaw Haileselassie; Benyam Seifu; Jemal Haidar Ali

doi:10.1155/2020/8032894

Prevalence of Vitamin A Deficiency among Preschool Children in Ethiopia: A Systematic Review and Meta-Analysis

Biomed Res Int. 2020 Feb 27:2020:8032894. doi: 10.1155/2020/8032894. eCollection 2020.

Authors

Zekariyas Sahile¹, Delelegn Yilma¹, Robel Tezera², Tadu Bezu³, Werissaw Haileselassie⁴, Benyam Seifu⁵, Jemal Haidar Ali⁶

Affiliations

¹ Ambo University, College of Medicine and Health Science, Department of Public Health, P.O. Box 19 Ambo, Ethiopia.
² Addis Ababa University, College of Health Science, Department of Medical Radiological Technology, P.O. Box 11950 Addis Ababa, Ethiopia.
³ Kotebe Metropolitan University, Menelik II Health Science and College of Medicine, Addis Ababa, Ethiopia.
⁴ Addis Ababa University, College of Health Sciences, School of Public Health, P.O. Box 11950 Addis Ababa, Ethiopia.
⁵ Ambo University, College of Medicine and Health Science, Department of Midwifery, P.O. Box 19 Ambo, Ethiopia.
⁶ Addis Ababa University, College of Health Science, School of Public Health, P.O. Box 27285 1000 Addis Ababa, Ethiopia.

Abstract

Background: Vitamin A deficiency is a major nutritional concern in lower-income countries. The aim of this systematic review and meta-analysis was to show the magnitude of vitamin A deficiency among preschoolers in Ethiopia.

Objective: The present study was aimed at synthesizing qualitatively and quantitatively the existing literature on the prevalence of VAD in preschool children in Ethiopia.

Methods: Studies were searched through the search engine of Google Scholar, Hinari, MEDLINE/PubMed, Cochrane Library, and Africa-Wide Information. Searching was made using the keywords/MeSH of vitamin A deficiency, xerophthalmia, night blindness, Bitot's spot, retinol, children, and Ethiopia. Data were analyzed and compared with the WHO threshold criteria to declare a public health problem. Heterogeneity among studies was assessed using a Cochran Q test and I ² statistics. A random-effects model with 95% confidence interval was used for prevalence estimations.

Results: Of the 13 studies included in clinical analysis, 12 of them reported the prevalence of night blindness and/or Bitot's spot among preschool children in Ethiopia which was above WHO cutoff point for the public health problem 1% and 0.5%, respectively. The prevalence of night blindness significantly decreased from moderate public health problem 4.2% (95% CI: 2.8%-5.7%) in a period from 1990 to 2004 to mild public health problem 0.8% (95% CI: 0.6%-1.0%) in a period from 2005 to 2019. Furthermore, statistically insignificant reduction was observed in the prevalence of Bitot's spot in a period from 1990 to 2004, 2.2% (95% CI: 1.3%-3.2%) to 1.8% (95% CI: 1.2%-2.3%) in a period from 2005 to 2019. Among 8 studies on subclinical vitamin A deficiency, 7 of them indicated a severe public health problem (>20%). The prevalence of subclinical vitamin A deficiency decreased from 55.7% (95% CI: 39.8%-71.6%) in a period from 1990 to 2004 to 28.3% (95% CI: 9.8%-46.7%) in a period from 2005 to 2019, but not statistically significant.

Conclusions: Despite the reduced proportion of night blindness and Bitot's spot, still both clinical and subclinical vitamin A deficiencies remain a public health problem in Ethiopia requiring strengthen intervention through the newly initiated health extension program.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Child, Preschool
Ethiopia / epidemiology
Female
Humans
Infant
Infant, Newborn
Male
Models, Biological*
Prevalence
Vitamin A Deficiency / epidemiology*
Vitamin A Deficiency / metabolism
Vitamin A Deficiency / pathology