Research Projects

Bitot’s spot is a useful indicator of vitamin A deficiency, especially in young children, but is not pathognomonic. Substantial non-response to MVAS at 6 and 12 months of follow-up suggests that presently in the Indian subcontinent, Bitot’s spot is a relatively crude indicator of severe current vitamin A deficiency. Thus for programmatic decisions and evaluation, public health burden of VAD should not be solely assessed through BS; it would be desirable to consider other important health consequences. The findings may also partially explain: (i) the recorded discrepancy between BS and low serum retinol prevalences at population level in India; and (ii) the fact that the predominant decline in BS prevalence, antedated a functioning universal vitamin A supplementation programme in India . This decline has, however, now stagnated for a considerable period despite an improvement in MVAS coverage suggesting that factors other than severe VAD deficiency may be operating. It would be useful to revisit the guidelines for management of individual children with BS.