Vitamin A deficiency in more than 30% of children in some Middle Eastern and African countries
The regions with the highest prevalence of Vitamin A deficiency (VAD) in children are Sub-Saharan Africa and South Asia.
Globally, an estimated 190 million preschool-aged children suffer from VAD. The World Health Organization (WHO) classifies VAD as a "severe public health problem" in any population where the prevalence exceeds 20%. In the hardest-hit regions of Africa and South Asia, prevalence rates frequently exceed 40–50%.
1. Regional Prevalence Overview
The following chart compares the estimated prevalence of Vitamin A deficiency among preschool children (6–59 months) by major region. [1]
- Sub-Saharan Africa: Has the highest prevalence rate (~48%), driven by limited dietary diversity and high rates of infectious diseases (measles, diarrhea) that deplete Vitamin A stores.
- South Asia: Follows closely (~44%), with significantly high absolute numbers due to population density in India, Pakistan, and Bangladesh.
2. Countries with the Highest Rates
While data availability varies by year and survey methodology (e.g., serum retinol testing vs. dietary recall), the following countries consistently report alarmingly high VAD rates in recent epidemiological reviews (2020–2024).
| Country | Prevalence / Risk (%) | Notes & Context |
|---|---|---|
| Mozambique | 71.2% | Among the highest recorded rates in recent reviews[2]. |
| Zambia | 56.0% | Persistent severe public health problem despite supplementation efforts[2]. |
| Afghanistan | 49.3% | High food insecurity contributes to severe widespread deficiency[2]. |
| Maldives | 43.8% | Surprisingly high rate likely linked to specific dietary patterns[2]. |
| Somalia | 33.3% | "Inadequate consumption" rates are even higher (61.1%)[3], linked to chronic crisis conditions[4]. |
| Pakistan | 37.0% | Prevalence varies significantly by province; affects ~63% of children in some deficiency studies[2][5]. |
| Ethiopia | ~30% | Regional variation is extreme; some studies show 81.1% of children have "inadequate consumption"[6]. |
| India | 17.5% (National) | Key Distinction: National average has dropped, but states like Jharkhand (43%) and Mizoram (>80% subclinical) remain severe hotspots[2][7]. |
Research Note: You may encounter conflicting data for Morocco. Older studies (late 90s/early 2000s) cited prevalence as high as 40.9%. However, more recent data indicates this has declined to approximately 9–22% following successful public health interventions.[8][9]
3. Critical Distinctions in the Data
As a researcher, it is important to distinguish between three common metrics used in these statistics:
- Biochemical Deficiency: Serum retinol < 0.70 µmol/L. This is the clinical gold standard for "deficiency."
- Inadequate Consumption: The percentage of children whose diet does not meet the Estimated Average Requirement (EAR). This number is often higher than the biochemical deficiency rate (e.g., Ethiopia at 81% consumption risk vs. ~30% clinical deficiency).
- Prevalence vs. Burden:
- Highest Prevalence (%): African nations (e.g., Mozambique, Somalia) have the highest percentage of children affected.
- Highest Burden (Number of Cases): India has the highest absolute number of VAD cases due to its sheer population size, despite having a lower national percentage than Mozambique.
4. Public Health Implications
In these high-prevalence regions, VAD is the leading cause of preventable childhood blindness (xerophthalmia) and significantly increases mortality risk from common childhood infections.
- Measles & Diarrhea: VAD impairs mucosal immunity, making these infections more lethal. In turn, these infections strip the body of existing Vitamin A, creating a vicious cycle.
- Supplementation Gaps: While programs like semi-annual "Child Health Days" (delivering high-dose Vitamin A capsules) have reduced mortality, coverage is inconsistent. For example, supplementation coverage in the DRC is estimated at only 53%, leaving nearly half the child population vulnerable.[5]
Recommendation for Further Research: If you are investigating association data, look for recent "Micronutrient Forum" reports or DHS (Demographic and Health Surveys) datasets, which often provide the raw granular data for specific sub-regions (like the disparity between Indian states).
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