Dietary practices and xerophthalmia among Indonesian children

The stated frequency with which 30 Indonesian children with corneal xerophthalmia and age/sex/neighborhood matched controls ordinarily consumed vitamin- and provitamin A-rich foods was compared. Controls were more frequent consumers of eggs (p < 0.05), fish (p < 0.05), dark green leafy vegetables (p < 0.05), carrots (p < 0.01), and carotene-containing fruits (p < 0.1). Similar data were collected on 358 children with Bitot's spots and on normal preschool age children in a country wide survey. Breast-feeding was more common among normals than among cases (p < 0.001). Normals were also more frequent consumers of mango and papaya during the 2nd and 3rd yr of life (p < 0.05); and of dark green leafy vegetables and eggs during the 3rd through 6th yr of life (p < 0.01). In two separate studies, differences in carotene consumption by normals and abnormals were confirmed by differences in their serum carotene levels. Approximately 80% of Indonesian families, with and without xerophthalmic children, consumed dark-green leafy vegetables at least once a day, and 99% at least once a week. Diet therefore appears to be an important factor in the genesis of xerophthalmia in Indonesia despite the availability of suitable provitamin A-rich foods.