RISK-FACTORS FOR XEROPHTHALMIA IN THE REPUBLIC-OF-KIRIBATI

Objectives: To identify risk factors for xerophthalmia in the Republic of Kiribati. Design: Case-control study. Setting: The Republic of Kir ibati. Subjects: 666 xerophthalmic preschool children (cases) and 816 children without xerophthalmia (controls) from a population-based samp le of 4619 children who participated in a xerophthalmia prevalence sur vey. Main outcome measures: Clinical signs of xerophthalmia (night bli ndness, Bitot's spots, corneal xerophthalmia and keratomalacia). Resul ts: Multivariable logistic regression models showed older age [1.35(1. 24, 1.47)] [odds ratio (95% confidence interval)]; male sex [1.32(1.05 , 1.67)]; recent diarrhea [1.45(1.10, 1.89)]; severe [3.82(2.73, 5.35) ], moderate [3.55(2.04, 6.18)], and mild [3.07(2.33, 4.04)] protein-en ergy malnutrition; current breast-feeding [0.30(0.19,0.46)]; higher fr equency of consumption of carotenoid-containing fruits and vegetables [0.93(0.80, 0.96)]; and the presence of a Foundation for the Peoples o f the South Pacific garden project [0.70(0.52, 0.93)] were each indepe ndently associated with xerophthalmia. A recent history of measles was associated with corneal xerophthalmia [7.73(1.78, 33.65)]. Conclusion s: These data provide further evidence of the relationship between xer ophthalmia and factors that may be amenable to intervention, and sugge st that greater availability and consumption of provitamin A carotenoi ds is associated with decreased risk of xerophthalmia among preschool children.