Conjunctival Impression Cytology with Transfer (CIC-T) detects Hypovitaminosis A in Nigerian Children

Abstract

Summary: Vitamin A deficiency is an important public hcalth problem in children under 5 years of age living in the tropics. We have previously demonstrated that Conjunctival Impression Cytology with transsef (CIC-T) is a simple procedure, which is adequately sensitive and specific as a screening tool for cpidemiological survey's of vitamin A status. The present study was designed to evaluate the utility of CIC-T and scrum retinal in malnourished children with kwashiorkor and children with chronic cholestasis. The study population comprised 15 cases of kwash iorkor, 5 cases of chronic cholestasis, and 20 healthy well-nourished controls, all aged less than 3 vcars. The mean serum retinol in the well-nourished children of 37.55 + 18.32mg/dl was significantly higher than the 17.2+11.53mg/dl in the kwashiorkor group (p=1),(0)1). The serum retinol in children suffering from chronic cholestasis had an inter mcdiate valuc of 23.59 +11.21mg/dl, which was similar to the levels in children with kwashiorkor (p=0.15) but significantly lower than that of the controls (p=0,03). This study demonstrates that a normal CIC-T smear is likely to indicate a scrum retinol of >20mg/dl (Odds Ratio=0.07.95% confidence Interval = 0.01-0).44. p=0).002). This study also confirms that CIC-T smear classification of normal and abnormal is the most predictive of serum retinal status. The simplicity; specificity: high positive predictive value and the acceptably low failure rate of CIC-T should make this test useful in pre dicting vitamin A status of children in this community: The nearly universal hypovita ininosis A in kwashiorkor in this study also confirms the need for vitamin A therapy in all children suffering from kwashiorkor