Conclusion

Xerophthalmia is an important public health problem in Gikongoro, and it is highly probable that other regions of Rwanda are also at significant risk. Surveys based on clinical signs and readily available dietary information should be done to determine the extent of the problem. With the increasing evidence that an adequate vitamin A status results in improvement in child health and survival, in addition to the well-known preventive effect of vitamin A against blindness, an intervention program to improve vitamin A intake is a priority [1-5]. Because vitamin A is affected by many factors [2], the control programme should be part of a general primary health-care programme that includes vitamin A supplementation by means of a regular megadose of retinol combined with vitamin E, immunization, water sanitation, health education, nutritional programmes (including efforts aimed at raising production of foods rich in vitamin A and other nutrients), good primary health-care services, family planning, and community participation. The success in reaching children and providing vitamin A on a permanent basis, by means of supplementation or other strategies, is a challenge and is strongly dependent on a global and integrated primary health-care system including community involvement.