Serum retinol and xerophthalmia among a prison population in Papua New Guinea.

Abstract

PURPOSE:

To estimate the prevalence of vitamin A deficiency (VAD) and one of its clinical manifestations, xerophthalmia, and examine the predictive value of nyctalopia and ocular signs for serum retinol concentrations among a prison population in Papua New Guinea.

METHODS:

A cross-sectional study of 148 prisoners and 9 guards; all males aged ≥18 years. Interview-based questionnaire; ocular examination; serum retinol concentration determination.

RESULTS:

Two guards had marginal (retinol <1.05-≥0.70 µmol/L) VAD. For prisoners: mean retinol was 0.84 ± 0.49 µmol/L; 43.9% (95% CI 35.9, 52.2) had VAD (retinol <0.70 µmol/L); 9.6% (95% CI 5.1, 17.0) self-reported nyctalopia prior to, and 36.1% (95% CI 27.7, 45.5) after incarceration; 10.9% (95% CI 6.7, 17.0) exhibited at least one sign of xerophthalmia (2 had fundus changes; all 4 with more than conjunctival xerosis alone had severe [<0.35 µmol/L] retinol deficiency). Prisoners with ocular signs were more likely than those without to have VAD (OR 10.4; 95% CI 2.5, 70.3; P < 0.001) and severe retinol deficiency (OR 19.1; 95% CI 5.5, 77.2; P < 0.001). Positive (PPV) and Negative (NPV) Predictive Values: of nyctalopia for any (PPV 62.9%; NPV 32.8%) and severe (PPV 25.7%; NPV 85.9%) retinol deficiency; of ocular signs for any (PPV 93.3%; NPV 38.2%) and severe (PPV 73.1%; NPV 87.8%) retinol deficiency, and VAD (PPV 86.5%, NPV 38.2%).

CONCLUSIONS:

VAD and xerophthalmia were present in this prison population. There may be VAD in the wider community. The former needs remedy and the latter deserves investigation. Self-reported nyctalopia was not a useful indicator of retinol deficiency. Absence of ocular signs was unhelpful for ruling out VAD.

• Authors: Garry Brian, Benoit Tousignant, Bernard J Venn, Robert McKay, Camilla Gould
• Journal: Ophthalmic epidemiology (Ophthalmic Epidemiol) Vol. 18 Issue 6 Pg. 288-94 (Dec 2011) ISSN: 1744-5086 [Electronic] England
• PMID: 22053839 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Vitamin A

Topics

• Adolescent
• Adult
• Aged
• Biomarkers (blood)
• Cross-Sectional Studies
• Humans
• Male
• Middle Aged
• Night Blindness (epidemiology)
• Papua New Guinea (epidemiology)
• Pilot Projects
• Prisons (statistics & numerical data)
• Surveys and Questionnaires
• Vitamin A (blood)
• Vitamin A Deficiency (epidemiology)
• Xerophthalmia (blood, epidemiology)
• Young Adult