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Meta-Analysis
. 2020 Feb 27:2020:8032894.
doi: 10.1155/2020/8032894. eCollection 2020.

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

Zekariyas Sahile  1 , Delelegn Yilma  1 , Robel Tezera  2 , Tadu Bezu  3 , Werissaw Haileselassie  4 , Benyam Seifu  5 , Jemal Haidar Ali  6
Affiliations
Meta-Analysis

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

Zekariyas Sahile et al. Biomed Res Int. .

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.

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Conflict of interest statement

All authors declared that they have no financial and nonfinancial competing interest.

Figures

Figure 1
Figure 1
PRISMA flow chart diagram describing selection of studies for systematic review and meta-analysis on the prevalence of vitamin A deficiency among preschool children in Ethiopia 1990-2019.
Figure 2
Figure 2
Forest plot of 13 studies on the prevalence of Bitot's spot among preschool children in Ethiopia, 2019.
Figure 3
Figure 3
Forest plot of 8 studies on the prevalence of subclinical vitamin A deficiency among preschool children in Ethiopia, 2019.
Figure 4
Figure 4
A funnel plot of studies conducted on the prevalence of night blindness in Ethiopia.
Figure 5
Figure 5
A funnel plot of studies conducted on the prevalence of Bitot's spot in Ethiopia.
Figure 6
Figure 6
A funnel plot of studies done on the prevalence of subclinical vitamin A deficiency in Ethiopia.
Figure 7
Figure 7
Forest plot of 13 studies on the prevalence of night blindness among preschool children in Ethiopia, 2019.
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