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Vitamin A deficiency is sufficiently prevalent in developing countries that Alfred Sommer, MD, and colleagues estimate up to 5 million children in Asia alone each year may develop xerophthalmia (Lancet 1981;1:1407-1408). Last year, after examining each of 3,481 preschool-aged rural Indonesian children seven times over 18 months, Sommer and colleagues reported that "the mortality rate among children with mild xerophthalmia [night blindness and/or Bitot's spots] was, on average, four times the rate, and in some age groups eight to 12 times the rate, among children without xerophthalmia.... Mild vitamin A deficiency was directly associated with at least 16% of all deaths in children aged from 1 to 6 years" (Lancet 1983;11:585-588). Following up this "quite unexpected" finding, the team undertook a study of 30,000 Indonesian children who had not yet developed even mild xerophthalmia. Youngsters from half of a group of paired villages were given a capsule containing 200,000 IU
Gunby P. 'Mild' vitamin A deficiency now major world problem? JAMA. 1984;252(22):3086. doi:10.1001/jama.1984.03350220010003
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