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  • Title: Diagnosis of night blindness and serum vitamin A level: a population-based study.
    Author: Hussain A, Kvåle G, Odland M.
    Journal: Bull World Health Organ; 1995; 73(4):469-76. PubMed ID: 7554018.
    Abstract:
    In a cross-sectional survey of 5420 children in northern Bangladesh, 124 were reported to have night blindness by their parents. Of these, 105 cases along with controls matched for age, sex, and neighbourhood had their scotopic vision examined under standard condition using a luxometer, underwent an ophthalmological examination, and had their serum vitamin A level determined. The mean serum vitamin A level was lowest among children identified as night blind by both their parents and the investigators (16.3 micrograms/dl; 95% confidence interval (CI), 13.9-18.7) and highest among those identified as not night blind by both their parents and the investigators (23.6 micrograms/dl; 95% CI, 21.3-25.9). The results show that parents' report of their children's night blindness had low sensitivity compared with diagnosis using standard observations of scotopic vision with a luxometer. A cross-sectional survey was carried out in Ranjpure district, northern Bangladesh, in 1992. Of 2101 households 5420 children 0-15 years old were selected. A total of 124 cases of night blindness and 124 controls were identified. Of these, 105 cases and 104 controls had their scotopic vision examined using a luxometer. 103 cases and 104 controls matched for age, sex, and neighborhood received an ophthalmological examination, and 87 cases and 97 controls had their serum vitamin A level measured. The mean serum vitamin A level was lowest among children identified as night blind by both their parents and the investigators (16.3 mcg/dl) and highest among those identified as not night blind by both their parents and the investigators (23.6 mcg/dl). Serum vitamin A level was lowest among those children classified as not night blind by their parents as well as the investigators. Of the 104 control children, 22 (21.1%) had moderate, 4 (3.8%) distinct, and 8 (7.7%) severe night blindness according to the luxometer readings. For the cases, serum vitamin A level was related to the severity of night blindness (p = 0.02), while for the controls the association was weaker (p = 0.14). In these groups, those with serum vitamin A 10 mcg/dl had an odds ratio for the occurrence of night blindness of 28.9 compared with the reference group with serum vitamin A levels or= 30 mcg/dl. A total of 53 cases (60.9%) and 42 controls (43.3%) according to parents' diagnoses had serum vitamin A levels 20 mcg/dl (p 0.05). Among those whose diagnosis was confirmed by observation of scotopic vision, 71.9% of the cases and 40.9% of the controls had serum vitamin A levels 20 mcg/dl (p 0.01). Of the 103 children with night blindness according to their parents' diagnosis, 38.8% were found to be suffering from ocular abnormalities upon ophthalmological examination, compared with 26.0% of the 104 controls (p = 0.07). Parents' report of their children's night blindness had low sensitivity compared with diagnosis using standard observations of scotopic vision with a luxometer.
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