Severe vitamin A deficiency in a rural village in the Hararge region of Ethiopia.

A total of 240 children were examined for vitamin A deficiency in a village in Hararge region of Ethiopia. Night blindness, Bitot's spots, corneal xerosis, corneal ulceration and corneal scars were observed in 69, 16, 2, 15 and 14 children, respectively, based on the most severe eye signs. Blood was collected from 76 children with eye signs and 9 other children selected at random. The concentration of retinol (vitamin A) in serum was < 0.35 mumol/l in 30.2% of children and the median serum retinol-binding protein, iron, transferrin saturation and ferritin levels were low while the parameters of iodine status, total triiodothyronine, total thyroxine and thyrotropin, were all within the normal range. Levels of IgG and IgM were elevated in 78.8% and 82.4% children, respectively, while C-reactive protein levels were elevated in 42.4% of children. There was a higher prevalence of wasting (33%) than stunting (10%) with an additional 8% of children being both stunted and wasted. In the 2 years prior to the study, there were 74 deaths of which 17 were reported to be associated with ruptured corneas. The community had been dependent on relief food aid for the previous 6 years.