Post-measles corneal ulceration in children in northern Nigeria: the role of vitamin A, malnutrition and measles

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Abstract
This work was prompted by the observation that corneal ulceration was apparently more common in young children in the guinea savannah area of northern Nigeria than in children in the tropical rainforest areas of southern Nigeria, where the intake of vitamin A, as the provitamin in red palm oil, is higher. Since corneal ulceration was usually seen in association with measles, a study was carried out to clarify the relationship between nutritional status, measles infection and vitamin A status in young children. The concentration of total retinol was measured in the plasma of well-nourished and malnourished children under three years of age, with or without a clinical record of recent measles. One hundred and twenty children were studied of whom 17 had corneal lesions. Malnutrition and measles were both found to depress the plasma concentrations of retinol and albumin. Measles depressed retinol levels (–20 to–30%) more than did malnutrition (–4 to–12%) while malnutrition had a greater depressing effect on albumin concentration (–23 to–30%) than did measles (–11 to–23%). The results support the hypothesis that corneal ulceration found in association with measles in northern Nigeria, although clinically similar to xerophthalmia, is not simply mediated through an effect of measles on the concentrations of vitamin A in plasma.