This short review summarizes all the published and unpublished reports on vitamin A deficiency in the Sudan in the last four decades. Different local terms used by people to indicate vitamin A deficiency were enlisted. There is evidence that vitamin A deficiency is a public health problem in eastern Sudan and among communities from western and southern Sudan living around Greater Khartoum, who were displaced from their homelands because of drought, famine conditions and civil unrest. There are reports indicative of vitamin A deficiency problem in the central and the far western provinces. There were no reports from the northern provinces. The need for a surveillance system was discussed.
PIP: Vitamin A deficiency is a world wide health problem following protein energy malnutrition. Recently, data have indicated the interrelationship between vitamin A deficiency and childhood respiratory infections, diarrhea, and measles. Medical articles and reports from the Sudanese Ministry of Health and the Helen Keller International were reviewed covering 4 decades to assess the extent of vitamin A deficiency. In a study of 1265 people over 3 years old in the Gezira area the incidence of deficiency was higher in children especially girls. Keratomalacia was higher in children especially girls. Keratomalacia was restricted to infants who were emaciated and marasmic with poor eyesight. The cause was neglected gastrointestinal derangement rather than vitamin A intake. In another study of 3461 children under 5 in 69 villages and 4 rural towns in eastern Sudan there was significant prevalence twice as high among girls than boys with a peak in the 2nd 1.2 of the 3rd year of life probably attributable to a staple of sorghum and avoidance of green leafy vegetables. A survey in western Sudan indicated focal distribution of the deficiency, and as a result of the drought of 1983-84 children may have become blind. A survey of children under 5 in a displaced community around the city of Omdurman using the sensitive plasma retinol-binding protein test to detect the deficiency showed that only 3 children out of 1441 had the protein level equal to or more than 3 mcg/dl, the normal level. Clinical signs of vitamin A deficiency were not manifest, however, mothers of 2.7% of boys and 5.8% of girls said that their children's eyesight was weak at night. Periodic surveys, health education, and vitamin A supplementation are needed.