OBJECTIVETo understand the prevalence of vitamin A deficiency (VAD) among children under six years of age in Tibet, China.

METHODSTotally, 1 257 children under six years of age were selected from two cities, two farming counties, two semi-farming counties and two livestock farming counties with stratified cluster sampling to asses VAD status in Tibet. Family information, children's feeding and disease history in the previous two weeks were collected by questionnaire. Blood specimen was collected from each child and serum was separated for detection of vitamin A concentration with microfluorescent spectrophotometry.

RESULTSTotally, 1 257 children under six years of age were surveyed, with 635 boys, 622 girls, 862 aged over two years, and 98.5% of Tibet nationality. Six cases of night blindness and two cases of xerophthalmia were detected from them, with prevalence of clinical VAD of 0.96%. Eighteen of 1071 mothers with children under six years of age were found suffering from night blindness, accounting for 1.7%. Clinical cases of VAD both in children and mothers came from all four sampling strata. Average serum concentration of vitamin A and prevalence of subclinical VAD (serum vitamin A lower than or equal to 0.70 micromol/L) was 1.15 micromol/L and 5.4% and 1.12 micromol/L and 4.7% in cities and livestock farming counties, respectively, significantly higher than those in farming (1.04 micromol/L and 11.0%) and semi-farming counties (1.05 micromol/L and 12.3%), respectively, as compared to average levels of 1.09 micromol/L and 8.4% in the autonomous region as a whole. Prevalence of subclinical VAD in children under six months and those aged six to eleven months were 22.2% and 13.3%, respectively, significantly higher than those in children aged one year (8.5%), two to three years (5.4%) and four to five years (7.9%), respectively. There was also significant difference in serum level of vitamin A between children at varied ages, but no significant difference both in serum level of vitamin A and prevalence of subclinical VAD between gender was found.

CONCLUSIONSIn general, status of VAD in children of Tibet was milder than that at national level. But, moderate subclinical VAD in some areas, such as farming and semi-farming counties, did exist, so vitamin A supplementation aiming to children, especially those under one year of age, in those areas should be urged.