Prevalence of ocular manifestations of vitamin A deficiency in children: A systematic review.
Level 4 - case-series / case-control
Systematic review of observational/cross-sectional prevalence studies
PubMed 39694460 · doi:10.1016/j.oftale.2024.12.011
What was done
Authors conducted a systematic review (search performed September 2022) to evaluate the prevalence of ocular manifestations caused by vitamin A deficiency in children aged 0 to 18 years. Observational studies without underlying preselected diseases were included, screened via Rayyan with duplicate removal and paired reading, and quality-assessed using the Agency for Healthcare Research and Quality (AHRQ) tool.
What was found
A total of 79 studies published between 1972 and 2020 were identified, predominantly from Asia (n = 42, 53.0%) and Africa (n = 28, 35.4%), with 4 from the Americas (Brazil) and 0 from Europe. The most frequently reported ocular manifestations were night blindness (reported in 69.6% of included articles) and xerophthalmia (reported in 38.0%). Diagnosis relied mostly on surveys (82.3%), followed by laboratory tests (32.0%), optometrist or ophthalmologist evaluations (25.3%), and trained personnel examinations (8.9%). Study settings were primarily general population cohorts (79.7%) and hospitals (15.2%). Pooled aggregate prevalence numbers for individual participants were not reported in the abstract.
Why it matters
Vitamin A deficiency-associated eye disease remains a substantial pediatric public health concern across multiple continents, particularly in Asia and Africa. The findings also emphasize that existing prevalence estimates rely heavily on subjective survey tools rather than standardized ophthalmic examinations.
Limits
The abstract does not report the total number of child participants or a meta-analytic pooled prevalence estimate. Over 80% of studies used survey-based diagnostic methods rather than clinical or biochemical confirmation, introducing substantial risk of misclassification bias. Evidence is geographically skewed with sparse data outside of Asia and Africa.
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