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Title: PREVALENCE AND FACTORS ASSOCIATED WITH XEROPHTHALMIA AMONG INMATES (2017)

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Background: Xerophthalmia is one of the clinical manifestation of Vitamin A Deficiency (VAD). Worldwide, VAD is an important public health problem that contributes to the global burden of disease. The greatest burden is in Africa and Southeast Asia. VAD is common in children and pregnant women in low-income countries. Globally, widespread vitamin A supplementation together with measles immunisation in at-risk populations has led to the decline of VAD and xerophthalmia. However, xerophthalmia prevalence is still high in the vulnerable communities of prisoners. The prison inmates are at risk because of monotonous diet of maize meal and beans which are not rich in vitamin A. Objectives: To determine the prevalence and the factors associated with xerophthalmia and the frequency of other eye conditions among inmates in Mbarara Central Prison. Design and methods: This was an analytical cross-sectional study conducted during the month of September 2016. We included both male (280) and female (28) inmates using proportionate stratified simple random sampling. We collected data on sociodemographic characteristics, medical, imprisonment factors and behavioural factors before imprisonment. We conducted complete visual assessment and examined inmates for signs of xerophthalmia using an illuminated magnifying loupe. We entered data into Excel and exported into Stata 13 for analysis. Results: A total of 308 inmates were enrolled in the study and majority were male 280 (90.9%) with a mean age of 34years (SD± 10.5) and average imprisonment duration of 27 months (SD± 18.9). Overall, 35.4% [95%CI, 30.2-40.9] had xerophthalmia. There were 109 (35.4%) inmates with night blindness, conjunctival xerosis 37 (12.0%), Bitot’s’ spots 27 (8.8%), corneal xerosis 4 (1.3%), corneal ulcer 2 (0.7%) and corneal scar 3 (0.9%). Stratified by gender, the prevalence was 37.3% among male inmate and 17.9% among females. The prevalence of xerophthalmia increased with increasing age with 51.7% of the inmates aged 50 years and above. In multivariate analysis, duration of imprisonment greater than 2 years, lack of education training were significantly associated with xerophthalmia. Other ocular morbidities were; allergic conjunctivitis, refractive errors, cataracts, conjunctival growth and glaucoma. Conclusion: The 35.4% prevalence of xerophthalmia is high and represents a significant health problem with 4 of every 10 inmates with xerophthalmia. We recommend feeding prison inmates with Vitamin A rich foods like orange sweet potatoes and periodic supplementation with vitamin A capsule by the prison health team.

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