SRI LANKA Last Updated: 2007-05-23

Vitamin and Mineral Nutrition Information System (VMNIS) WHO Global Database on Vitamin A Deficiency The Vitamin A Deficiency database includes data by country based on xerophthalmia and/or serum or plasma retinol concentration

Prevalence of xerophthalmia (%) Serum / plasma retinol concentration (µmol/l)

Prevalence (%) Reference Notes Age Sample Mean SD Level Date Location and sample descriptor Sex (years) size Current Previous X1B X2 X3A X3B XS <0.35 <0.70 < 1.05 XN XN General Line N 2003 National: SAC: Total B 9.00-15.99 2528 0.30 4926 * SAC by sex F 9.00-15.99 1177 0.20 SAC by sex M 9.00-15.99 1351 0.40

L 2002 Yatiyantota: SAC B NS 283 0.00 0.30 0.30 2.10 5815 * 1 Yatiyantota: SAC B NS 162 18.5 1.20 0.52

N 2002 National: SAC: Total B 10.00-15.99 6264 0.40 5816 * SAC by sex F 10.00-15.99 NS 0.30 SAC by sex M 10.00-15.99 NS 0.40 SAC by age B 10.00-10.99 1757 0.30 SAC by age B 11.00-11.99 1376 0.60 SAC by age B 12.00-12.99 1631 0.30 SAC by age B 13.00-13.99 412 0.20 SAC by age B 14.00-14.99 520 0.40 SAC by age B 15.00-15.99 560 0.20

LR 2001 Kataragama area: SAC by group: Intervention B 5.00-13.99 92 1.20 0.41 5802 * Kataragama area: SAC by group: Non-intervention B 5.00-13.99 101 1.27 0.44

L 1999P Colombo urban: Girls infected F 14.00-18.99 163 1.02 0.41 4807 * Colombo urban: Girls not infected F 14.00-18.99 157 1.13 0.44 Colombo rural: Girls infected F 14.00-18.99 23 0.83 0.29 Colombo rural: Girls not infected F 14.00-18.99 178 0.97 0.33

L 1996P Plantations: PW F 17.00-45.99 309 8.70 11.90 4420 * Plantations: PW F 17.00-45.99 277 3.6 46.2

N 1995 -1996 National: Pre-SAC B 0.50-5.99 2869 0.80 2716 * 2 National: Pre-SAC B 2.00-5.99 NS 0.80 3 National: Pre-SAC: Total B 0.50-5.99 1750 9.0 35.369.9 0.86 4 Pre-SAC by sex F 0.50-5.99 852 8.3 34.569.7 0.86 5 Pre-SAC by sex M 0.50-5.99 888 9.6 36.0 70.2 0.87 6 Pre-SAC by age B 0.50-0.99 391 9.0 34.8 70.5 0.86 7 Pre-SAC by age B 2.00-3.99 665 8.5 34.2 68.2 0.88 8 Pre-SAC by age B 4.00-5.99 704 9.5 36.6 71.2 0.85 9 Pre-SAC by sex and age F 0.50-0.99 182 0.85 10 Pre-SAC by sex and age F 2.00-3.99 308 0.90 11

© WHO Global Database on Vitamin A Deficiency Vitamin and Mineral Nutrition Information System (VMNIS) WHO Global Database on Vitamin A Deficiency The Vitamin A Deficiency database includes data by country based on xerophthalmia and/or serum or plasma retinol concentration

SRI LANKA Last Updated: 2007-05-23

Prevalence of xerophthalmia (%) Serum / plasma retinol concentration (µmol/l)

Prevalence (%) Reference Notes Age Sample Mean SD Level Date Location and sample descriptor Sex (years) size Current Previous X1B X2 X3A X3B XS <0.35 <0.70 < 1.05 XN XN General Line

N 1995 -1996 Pre-SAC by sex and age F 4.00-5.99 361 0.89 2716 12 Pre-SAC by sex and age M 0.50-0.99 198 0.89 13 Pre-SAC by sex and age M 2.00-3.99 357 0.87 14 Pre-SAC by sex and age M 4.00-5.99 343 0.86 15 Pre-SAC by province: Central B 0.50-5.99 NS 22.3 Pre-SAC by province: North Central B 0.50-5.99 NS 57.3 Pre-SAC by province: North Western B 0.50-5.99 NS 46.3 Pre-SAC by province: Sabaragamuwa B 0.50-5.99 NS 51.3 Pre-SAC by province: Southern B 0.50-5.99 NS 42.5 Pre-SAC by province: Uva B 0.50-5.99 NS 35.0 Pre-SAC by province: Western B 0.50-5.99 NS 24.3

D 1991P 5 districts: PW: Total F 15.00-45.99 496 1.00 1.20 0.00 0.00 0.00 0.00 2029 * PW by district: Colombo F 15.00-45.99 320 0.60 0.30 0.00 0.00 0.00 0.00 PW by district: Kurunegala F 15.00-45.99 61 1.70 3.40 0.00 0.00 0.00 0.00 PW by district: Kegalle F 15.00-45.99 32 0.00 3.10 0.00 0.00 0.00 0.00 PW by district: Badulla F 15.00-45.99 35 2.80 0.00 0.00 0.00 0.00 0.00 PW by district: Galle F 15.00-45.99 48 2.40 4.20 0.00 0.00 0.00 0.00 Colombo district: PW F 15.00-45.99 320 7.5 Kurunegala district: PW F 15.00-45.99 59 10.2 Kegalle district: PW F 15.00-45.99 32 12.5 Badulla district: PW F 15.00-45.99 35 5.7 Galle district: PW F 15.00-45.99 48 8.3

S 1985 Colombo: SAC B NS 4210 0.10 139a * S 1984 Colombo: SAC B NS 2546 0.00 139b * S 1983 Colombo: SAC B NS 5522 0.20 139c * S 1982 Colombo: SAC B NS 7198 1.20 139d * S 1981 Colombo: SAC B NS 3973 0.20 139e * NR 1975 -1976 National: Pre-SAC: Total B 2.00-5.99 9536 1.00 289 * National: Pre-SAC: Total B 0.50-5.99 13450 1.10 Pre-SAC by age B 2.00-2.99 2370 0.60 Pre-SAC by age B 3.00-3.99 2497 1.40

SRI LANKA Last Updated: 2007-05-23

Prevalence of xerophthalmia (%) Serum / plasma retinol concentration (µmol/l)

Prevalence (%) Reference Notes Age Sample Mean SD Level Date Location and sample descriptor Sex (years) size Current Previous X1B X2 X3A X3B XS <0.35 <0.70 < 1.05 XN XN General Line

NR 1975 -1976 Pre-SAC by age B 4.00-4.99 2493 0.90 289 Pre-SAC by age B 5.00-5.99 2176 1.40 Pre-SAC by age B 0.50-0.99 1230 0.10 Pre-SAC by age B 1.00-1.99 2598 0.20 Pre-SAC by age B 2.00-2.99 2425 0.80 Pre-SAC by age B 3.00-3.99 2511 1.40 Pre-SAC by age B 4.00-4.99 2503 1.40 Pre-SAC by age B 5.00-5.99 2183 2.10 Pre-SAC by SHS area: Anuradhapura B 2.00-5.99 648 0.50 Pre-SAC by SHS area: Badulla B 2.00-5.99 664 0.80 Pre-SAC by SHS area: Batticaloa B 2.00-5.99 642 1.30 Pre-SAC by SHS area: Colombo B 2.00-5.99 664 1.20 Pre-SAC by SHS area: Galle: B 2.00-5.99 663 1.10 Pre-SAC by SHS area: Jaffna B 2.00-5.99 626 0.60 Pre-SAC by SHS area: Kalutara B 2.00-5.99 617 0.30 Pre-SAC by SHS area: Kandy B 2.00-5.99 629 1.10 Pre-SAC by SHS Area: Kegalle B 2.00-5.99 625 2.60 Pre-SAC by SHS Area: Kurunegale B 2.00-5.99 628 0.50 Pre-SAC by SHS area: Matale B 2.00-5.99 638 0.80 Pre-SAC by SHS area: Matara: B 2.00-5.99 646 2.30 Pre-SAC by SHS area: Puttalam B 2.00-5.99 672 0.60 Pre-SAC by SHS area: Ratnapura: B 2.00-5.99 637 0.90 Pre-SAC by SHS area: Vavuniya B 2.00-5.99 623 0.50 Pre-SAC by SHS area: Anuradhapura B 0.50-5.99 900 0.70 Pre-SAC by SHS area: Badulla B 0.50-5.99 895 1.00 Pre-SAC by SHS area: Batticaloa B 0.50-5.99 894 0.70 Pre-SAC by SHS area: Colombo B 0.50-5.99 899 0.00 Pre-SAC by SHS area: Galle B 0.50-5.99 897 1.40 Pre-SAC by SHS area: Jaffna B 0.50-5.99 893 0.40 Pre-SAC by SHS area: Kalutara B 0.50-5.99 899 0.90 Pre-SAC by SHS area: Kandy B 0.50-5.99 893 1.00 Pre-SAC by SHS area: Kegalle B 0.50-5.99 896 2.30 Pre-SAC by SHS area: Kurunegale B 0.50-5.99 896 1.00 Pre-SAC by SHS area: Matale B 0.50-5.99 899 0.70 Pre-SAC by SHS area: Matara B 0.50-5.99 897 2.20 Pre-SAC by SHS area: Puttalam B 0.50-5.99 900 0.30 Pre-SAC by SHS area: Ratnapura: B 0.50-5.99 896 2.00 Pre-SAC by SHS area: Vavuniya B 0.50-5.99 896 0.70

SRI LANKA Last Updated: 2007-05-23

Prevalence of xerophthalmia (%) Serum / plasma retinol concentration (µmol/l)

Prevalence (%) Reference Notes Age Sample Mean SD Level Date Location and sample descriptor Sex (years) size Current Previous X1B X2 X3A X3B XS <0.35 <0.70 < 1.05 XN XN General Line

NR 1975 -1976 Kandy and Ratnapura: Pre-SAC: Total B 0.50-5.99 346 5.0 1.07 289 Pre-SAC by age B 4.00-5.99 139 6.0 1.10

Reference No: 4926 General notes: Nationally representative sample. Schools selected from 9479 non-fee-levying, state-run schools using multi-stage stratified sampling. Stratification at provincial level with representation of all 9 provinces, by functional type of school and from rural and urban areas. Survey part of a larger study sponsored by the National Education Commission (NEC).

Reference No: 5815 General notes: Facility based survey in Yatiyantota Medical Officer of Health(MOH)/Divisional Director of Health Services (DDHS) area, Kegalle district, Sabaragamuwa province. Report of children from two randomly selected schools in which vitamin A supplementation was not carried out. Note 1 Sample size for XN = 284. Sample size for XS = 278.

Reference No: 5816 General notes: Two-stage PPS cluster sampling. Nationally representative sample of students from public school grades 5 to 10. Primary sampling unit was the district (n=25). From each district, 12 schools selected for a total of 144 schools. One or two classes from each of the gades 5 through 10 were randomly selected from each school. Reference No: 5802 General notes: Baseline data for facility-based, double-blind, placebo-controlled trial conducted in school children at 2 rural schools in the Kataragama area of Moneragala district in southern Sri Lanka. The Kataragama area is in the dry zone, which is endemic for malaria with unstable transmission. During the study period, malaria transmission was low in the area as well as the rest of the country. Retinol measured in subsample of children enrolled in one class of all grades. Serum retinol converted from µg/dL to µmol/L. Reference No: 4807 General notes: Survey designed to assess effect of helminthic infection on nutritional status. Facility based study (schools) in Colombo (urban) and in a rural area (30 km from Colombo). Sample comprised of 383 urban girls and 231 rural girls. Results provided by infection status and location only. SR concentrations converted from µg/dL to µmol/L. Reference No: 4420 General notes: Study designted to assess iron, zinc and vitamin A status in plantation workers during pregnancy and postpartum. Plantation workers (10-26 weeks postpartum) selected from largest plantation in 5 of 6 regions belonging to Sri Lanka State Plantations Corporation. Reference No: 2716 General notes: Two-stage stratified PPS cluster sampling. Sample nationally representative but excludes North and East provinces. Stratified by low and high prevalence of X1B as observed in the 1975 survey. Sample comprised 60 clusters of approximately 100 housing units from 30 DS divisions. Plasma retinol concentrations converted from µg/dL to µmol/L. Note 2 Report states weighted prevalences used, but methodology not provided. Stated sample size for all measures in this age group was 2869 and 19 cases of X1B present (0.66%), but number of children assessed for Bitot's spots not stated. Note 3 Report states weighted prevalences used, but methodology not provided. Note 4 Median: 0.84 µmol/L Note 5 Median: 0.85 µmol/L Note 6 Median: 0.82 µmol/L Note 7 Median: 0.84 µmol/L Note 8 Median: 0.86 µmol/L Note 9 Median: 0.80 µmol/L Note 10 Median: 0.85 µmol/L Note 11 Median: 0.87 µmol/L Note 12 Median: 0.81 µmol/L Note 13 Median: 0.83 µmol/L Note 14 Median: 0.83 µmol/L Note 15 Median: 0.80 µmol/L

Reference No: 2029 General notes: Sample selected from maternity hospitals from the districts of Colombo, Kurunegala, Kegalle, Badulla and Galle. Sample included PW having clinically normal pregnancy and not receiving vitamin A supplement only. VAD status measured at early stage of pregnany (<20 weeks). Disaggregated serum retinol data also available for late pregnancy and socioeconomic status. Reference No: 139a General notes: Sample comprised of children from 154 schools in Colombo Municipal Area. Reference No: 139b General notes: Sample comprised of children from 154 schools in Colombo Municipal Area. Reference No: 139c General notes: Sample comprised of children from 154 schools in Colombo Municipal Area. Reference No: 139d General notes: Sample comprised of children from 154 schools in Colombo Municipal Area. Reference No: 139e General notes: Sample comprised of children from 154 schools in Colombo Municipal Area. Reference No: 289 General notes: PPS sampling of rural population from 15 health districts (SHS areas). Serum retinol determined only for subsample of every 5th child from 2 health districts (Ratnapura and Kandy). Serum retinol data not nationally representative.

Reference 139 Tilden R. Prevention and control of vitamin A deficiency, xerophtalmia, and nutritional blindness in Sri Lanka; 1986 Sept 15-Mar 1 [assignment report]. Sri Lanka, World Health Organization, Regional Office for South-East Asia, 1986.

Reference 289 Brink EW, Perera WD, Broske SP, Cash RA, Smith JL, Sauberlich HE, Bashor MM. Vitamin A status of children in Sri Lanka. American Journal of Clinical Nutrition, 1979, 32 :84-91.

Reference 2029 Jayasekera JPDJS, Atukorala TMS, Seneviratne HR. Vitamin A status of pregnant women in five districts of Sri Lanka. Asia-Oceania Journal of Obstetrics and Gynaecology, 1991, 17 :217-224.

Reference 2716 Ministry of Health and Indigenous Medicine, Medical Research Institute. Vitamin A deficiency status of children in Sri Lanka 1995/1996 [survey report]. Dehiwela, AJ Prints, 1998.

Reference 4420 de Silva LD, Atukorala TM. Micronutrient status of plantation workers in Sri Lanka during pregnancy and postpartum. Journal of Obstetrics and Gynaecology Research, 1996, 22 :239-246.

Reference 4807 Atukorala TMS, Lanerolle P. Soil-transmitted helminthic infection and its effect on nutritional status of adolescent schoolgirls of low socioeconomic status in Sri Lanka. Journal of Tropical Pediatrics, 1999, 45 :18-22.

Reference 4926 Pathmeswaran A, Jayatissa R, Samarasinghe S, Fernando A, de Silva RP, Thattil RO, de Silva NR. Health status of primary schoolchildren in Sri Lanka. Ceylon Medical Journal, 2005, 50 :46-50.

Reference 5802 Mahawithanage ST, Kannangara KK, Wickremasinghe R, Chandrika UG, Jansz Er, Karunaweera ND, Wickremasinghe AR. Impact of vitamin A supplementation on health status and absenteeism of school children in Sri Lanka. Asia Pacific Journal of Clinical Nutrition, 2007, 16 :94-102.

Reference 5815 Madatuwa TMJC, Mahawithanage STC, Chandrika UG, Jansz ER, Wickremasinghe AR. Evaluation of the effectiveness of the national vitamin A supplementation programme among school children in Sri Lanka. British Journal of Nutrition, 2007, 97 :153-159.

Reference 5816 Jayatissa R and Ranbanda RM. Prevalence of challenging nutritional problems among adolescents in Sri Lanka. Food and Nutrition Bulletin, 2006, 27 :153-160.

Reference 119 Atukorala S. Control of vitamin A deficiency and studies on vitamin A in Sri Lanka. In: WHO/SEARO Proceedings-Regional meeting on vitamin A, latest advances in the control of vitamin A and its impacts on health; 1988 Nov 3-5; Jakarta, Indonesia. 1988

Reference 4972 Piyasena C, Mahamithawa AMASB. Assessment of anaemia status in Sri Lanka 2001 [survey report]. Colombo, Ministry of Health, Nutrition and Welfare, Department of Health Services, Medical Research Institute, 2003.

Reference 5371 Piyasena C. Case studies of successful micronutrient programs: the Sri Lankan experience. Paper presented at a workshop on "Successful Micronutrient Programs" held at the International Union of Nutritional Sciences. Vienna, 2001.