BRIEF REPORTS 9. Klein J, Feigin R. Report of the Task Force on Diagnosis and Management of Meningitis. Pediatrics 1986; 78 (Suppl): 959-82. 10. Koutouby A, Habibullah J. Neonatal sepsis in Dubai, United Arab Emirates. J Trop Pediatr 1995; 41: 177-80. II. Overall J. Neonatal bacterial meningitis. J Pediatr 1970: 76: 499-511. 12. Wu S, Chang Y, Tsai C. Bacterial meningitis in neonates. Acta Paediatr Sin 1990; 31: 110-15. .' Risk Factors for Subclinical Vitamin A Deficiency in Children Under the Age of 6 Years by Devendra W, Khandait', N. D. Vasudeo', Sanjay P. Zodpey", and D. T. Kumbhalkarb •Department of Preventive and Social Medicine and bDepartment of Pathology, Government Medical College, Nagpur 440003, M. S., India Summary The present study was carried out to investigate risk factors for subclinical vitamin A deficiency in children under 6 years of age in the urban slums of Nagpur, India. The study included 308 nonxerophthalmic children selected randomly from the study population. On the basis of conjunctival impression cytology the prevalence of subclinical vitamin A deficiency was estimated to be 35.7 per cent. The current study recognised a significant association between female gender, illiterate mother, lower socioeconomic status, more than two children under 5 years of age at home, undernutrition, history of diarrhoea, measles, acute respiratory infections, and subclinical vitamin A deficiency on univariate analysis. Logistic regression analysis identified significance of female gender, more than two children under 5 years of age at home, undernutrition, and measles in the outcome of subclinical vitamin A deficiency. Estimates of attributable risk proportions and population attributable risk proportions for significant and preventable risk factors confirmed tbeir etiological and preventable role in subclinical vitamin A deficiency respectively. Introduction Vitamin A deficiency has long been recognized as a major public health problem and it is one of the common causes of blindness in preschool children in many developing countries including India.] Although exten- sive literature is available regarding risk factors for xerophthalmia, no attempt was made to study risk factors for subclinical vitamin A deficiency. With this background, together with the fact that prevalence of subclinical vitamin A deficiency is fairly high (i.e., 25-86 per cent) in preschool children among Indian populations,2-$ we performed a study to inves- tigate risk factors for subclinical vitamin A deficiency in children under the age of 6 years residing in urban slums in Nagpur, India. Materials and Methods The present study was undertaken in two urban slums (Hasanbagh and Shivankar-nagar) which were selected Correspondence: Dr Devendra W. Khandait, clo Mr Dnyanesh- war Admane, 15 Kukde Layout, Nagpur-440027, M. S. India. Tel. 0712-746790. randomly out of 23 slums which are affiliated to the field practice area of the Urban Health Centre, Department of Preventive and Social Medicine, Government Medical College, Nagpur, India. The baseline survey observed 999 non-xerophthalmic children, under the age of 6. Because of feasibility and cost, conjunctival impression cytology (CIC) was performed randomly in every third non-xerophthalmic child, Thus 328 non-xerophthalmic children were subjected for CIC, but results could be interpreted in only 308 children. CIC was performed by standard procedure.6 Specimens were graded as normal if goblet cells/abundant mucin spots were present (previous stages 0 and I) or abnormal if enlarged epithelial cells were present and goblet cells and mucin spots were absent (previous stages 2-5). If the specimen from either eye was normal, the child was graded as non-deficient. In the present study risk factors included; age> I year, female gender, illiterate mother, illiterate father, birth order> 3, low socioeconomic status, more that two siblings under 5 years old, undernutrition, history of diarrhoea, measles, acute respiratory infection and worm infestations. For measurement of risk factors standard definitions and criteria described in the literature were followed.7•s The socioeconomic status was assessed by Journal of Tropical Pediatrics Vol. 46 August 2000 239 411