scholarly journals National immunisation days and vitamin A distribution in Mali: has the vitamin A status of pre-school children improved?

2003 ◽  
Vol 6 (3) ◽  
pp. 233-240 ◽  
Author(s):  
JF Schémann ◽  
A Banou ◽  
D Malvy ◽  
A Guindo ◽  
L Traore ◽  
...  

AbstractObjective:The impact on vitamin A status of the distribution of vitamin A during national immunisation days (NIDs) has not been well established despite strong promotion by international agencies and donors. Using a pre–post design, the change in prevalence of vitamin A deficiency was examined in pre-school children in Mali.Design:Two cross-sectional surveys were conducted in Mopti region, the first in March 1997 before this strategy was adopted and the second in March 1999, four-and-a-half months after a mass distribution of vitamin A during NIDs.Subjects and setting:We compared the vitamin A status of children aged 12 to 66 months targeted in 1999 by NIDs with the status of children in the same age group in 1997. Infectious events of the previous two weeks were concurrently recorded. Within the 1999 sample, the status of recipient and non-recipient children was also compared.Results:In 1997, the prevalence of xerophthalmia (defined by the presence of night blindness and/or Bitot spots) was 6.9% (95% confidence interval (CI) 5.1–9.2) and the modified retinol dose response (MRDR) test proved abnormal in 77.8% of 12–66-month-old children (95% CI 68.27–85.17). In 1999 this picture had improved significantly, both for xerophthalmia prevalence, 3.3% (95% CI 2.1–5.2), and abnormal MRDR test response, 63.1% (95% CI 54.25–71.23). The infectious morbidity rates between 1997 and 1999 tended to decrease. No significant improvement was found among children older than those targeted by NIDs. In 1999, children who received vitamin A had a lower risk for xerophthalmia (3.0% for recipients vs. 8.7% for non-recipients) and experienced fewer infectious events.Conclusions:The clinical and biological vitamin A status of pre-school children improved between 1997 and 1999. Mass distribution of vitamin A appears to reduce the occurrence of xerophthalmia and would seem to be associated with a decrease in other related illnesses. Vitamin A supplementation during NIDs should be given a high priority when vitamin A deficiency remains a public health problem.

2009 ◽  
Vol 79 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Emmanuel M. Kafwembe ◽  
James Chipipa ◽  
Eric Njunju ◽  
Roma Chilengi

The main objective of the study was to determine the vitamin A status of Zambian children less than five years of age in a community where strategies of vitamin A supplementation and consumption of vitamin A fortified sugar have been introduced. In a cross-sectional study, a total of 537 children were enrolled. Their vitamin A status was measured using the modified relative dose response (MRDR) test. Their vitamin A status was compared to the status measured using a similar method in 1996, before vitamin A supplementation through capsule distribution and fortification of sugar was implemented as strategies to reduce vitamin A deficiency in the country. Results showed that the vitamin A status of children improved markedly as a result of these strategies.


2010 ◽  
Vol 4 (6) ◽  
pp. 255 ◽  
Author(s):  
Endang Achadi ◽  
Siti Arifah ◽  
Siti Muslimatun ◽  
Trisari Anggondowati ◽  
Asih Setiarini

Di Indonesia, kekurangan Vitamin A masih menjadi masalah kesehatan masyarakat yang penting seperti terlihat pada balita penderita vitamin A defisiensi subklinis yang tinggi (50%). Hal tersebut akan berpengaruh terhadap berbagai fungsi tubuh yang antara lain meliputi sistem imun, penglihatan, sistem reproduksi dan diferensiasi sel. Tujuan dari penelitian ini adalah untuk mengetahui kontribusi konsumsi minyak yang diperkaya vitamin A dalam memperbaiki status vitamin A dan hemoglobin balita. Penelitian dengan disain studi intervensi Before-After ini dilaksanakan pada anak sehat berusia 7-10 tahun yang diberi obat cacing sebelum intervensi dilakukan. Pengukuran serum retinol dan hemoglobin dilakukan sebelum dan 3 bulan setelah intervensi . Minyak yang difortifikasi vitamin A telah disediakan di warung/ toko di sekitar tempat tinggal responden. Untuk meningkatkan demand, penelitian ini dilengkapi dengan pendekatan pemasaran sosial yang dilakukan pihak lain. Secara umum tidak terlihat perubahan status gizi, tetapi prevalensi anemia turun dari 21,8% menjadi 11,6%. Sementara, prevalens vitamin A defisiensi ditemukan lebih rendah pada anak yang mengkonsumsi ³12 minggu (26,6%) daripada yang mengkonsumsi < 12 minggu (42%) . Hasil tersebut dapat dijadikan pertimbangan untuk merekomendasikan agar minyak difortifikasi vitamin A.Kata kunci: Defisiensi vitamin A, anak sekolah, minyak fortifikasiAbstractVitamin A deficiency (VAD) remains as one of significant public health problems in Indonesia. Around 50% of under five children are suffering from subclinical VAD. Deficiency of vitamin A will affect several important role in the body, such as immune system, vision, reproductive system and cell differentiation. Therefore, guarding Indonesian children to be free from VAD is crucial for their quality as Human Resources. We assessed the impact of the consumption of vitamin A fortified cooking oil on the improvement of vitamin A and hemoglobin status among school children in urban slum area in Makassar City. The study was an intervention design Before-After. Healthy school children 7-10 years were selected from schools and de-wormed before the intervention. Serum retinol and hemoglobin was measured at baseline and at 3 months after. Fortified oil was made available through distribution at shops and accompanied with social marketing. Eventhough overall there was no change in VAD prevalence, the VAD prevalence is lower among children who consumedfortified oil ³12 weeks (26.6%) compared to those who consumed <12 weeks (42%). Prevalence of anemia decreased from 21.8% to 11.6%. We recommended that fortified oil is made mandatory.Key words: Vitamin A deficiency, school children, fortified oil


Author(s):  
Nivedita Sinha ◽  
Rajesh R. Sinha ◽  
Ajay Krishna ◽  
Rashmi Singh

Background: Vitamin A deficiency (VAD) is a major preventable public health problem. Prevalence of VAD in preschool children was 5.7% (India), and 4.5% (Bihar). India is implementing biannual Vitamin A Supplementation (VAS) since 2007 along with 80 other countries. VAS was originally proposed as a short term measure, followed by dietary improvement. Since vulnerability to VAD is more in high priority districts (HPDs), it was deemed worthwhile to study the extent to which VAS programme is utilized in the 10 HPDs of Bihar with respect to the processes involved and the ultimate outcome of empowering the community with knowledge and capacity to combat VAD on their own.Methods: Cross sectional observational study conducted in 6 randomly selected blocks and 5 session sites per block of the 10 HPDs. 300 sites sampled for processes and 893 caregivers interviewed for their knowledge.Results: Out of 300 sites, 269 sites found functional, 30.85% sites had due lists and 30.11% had MCP cards; 20.44% had adequate VA. IEC displayed at 52.78% and 71.3% sessions conducted in shade. In 79.55% sites efforts made to determine age of child before administration. Correct use of recommended spoon known to 80.66%, benefits of VA to 76.57% and diseases due to VAD to 81.7% of FLWs. Knowledge regarding VA good in 33.4% of caregivers, average in 35.5%, and poor in 30.9%.Conclusions: Crucial gaps found in necessary inputs and conduct of VAS. Community knowledge found lacking for sustainable programme withdrawal. Better programme management will improve utilization. 


Author(s):  
Augustin Nawidimbasba ZEBA ◽  
Jean Fidèle Bationo ◽  
Olivier Ouahamin Sombié ◽  
Jeoffray Diendéré

Background: Vitamin A deficiency (VAD) is still a public health problem across the globe and also in Burkina Faso, especially for under-five-years-old children. Since less information is available about the prevalence of VAD among the primary school children, this study aimed to study this area. Methods: A randomised double-blind placebo-controlled trial was conducted to assess the effect of high dose of vitamin A (VA) and daily zinc versus high dose of VA and daily zinc placebo (6 days per week) during four months among the primary school children. Of the total number of 200 school children, 100 were allocated to two random groups. Participants’ gender, age, weight, and height were measured, a blood smear was performed for malaria diagnosis, stool samples were collected for intestine parasites’ assessment, and blood samples were collected for haemoglobin and serum retinol measurement. Results: Baseline data of 183 school children were analysed and the findings showed that 20.6% of the school children were underweight (23.2% in girls vs. 16.5% in boys; P = 0.043). Anemia affected 36.2%, 39% had Plasmodium Falciparum, and 37.6% had intestine parasites. Furthermore, VAD prevalence was 46.1% (51.0% in boys vs. 41.2% in girls; P = 0,072). Conclusion: Among primary school children in the Western part of Burkina Faso, VAD is not only higher than other regions of the country, but also twice the critical level and defined as a severe public health problem by WHO. This result calls for action among the primary school children and recalls the importance of taking strategies against VAD among under-five-year-old children.


2011 ◽  
Vol 15 (4) ◽  
pp. 568-577 ◽  
Author(s):  
Avula Laxmaiah ◽  
Madhavan K Nair ◽  
Nimmathota Arlappa ◽  
Pullakhandam Raghu ◽  
Nagalla Balakrishna ◽  
...  

AbstractObjectiveTo assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children.DesignA community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure.SettingRural areas of eight states in India.SubjectsPre-school children and their mothers were covered.ResultsA total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0·8 %. The total ocular signs were significantly higher (P < 0·001) among boys (2·6 %) compared with girls (1·9 %) and in older children (3–4 years) compared (P < 0·001) with younger (1–2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR = 3·8; 95 % CI 2·9, 5·0), labourers (OR = 2·9; 95 % CI 2·1, 3·9), illiterate mothers (OR = 2·7; 95 % CI 2·2, 2·3) and households without a sanitary latrine (OR = 5·9; 95 % CI 4·0, 8·7). Subclinical VAD (serum retinol level <20 μg/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %.ConclusionsThe study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1851-1851
Author(s):  
Rui Wang ◽  
Chen Jing ◽  
Yichun Hu ◽  
Xiaoguang Yang ◽  
Lichen Yang

Abstract Objectives Vitamin A deficiency is recognized as a major public health nutrition issue in developing countries including China. It is one of the most common micronutrient deficiencies, yet vitamin A status of the elderly in China paucity of data since 2002. We sought to evaluate Chinese elderly aged 60 years and above in vitamin A status, and to compare vitamin A insufficiency between year 2002 and 2012. Methods We compared serum retinol concentrations from the China National Nutrition and Health Survey 2002 (CNNHS 2002), with CNNHS data collected during 2010 through 2012 (CNNHS 2010–2012). Complete data were available for 4933 elderly participants in CNNHS 2002 and 5613 elderly participants in CNNHS 2010–2012. Results The mean serum retinol concentration was 1.69 (95% confidence interval (CI): 1.68–1.71) μmol/L during CNNHS 2002 and increase to 1.98 (1.96–2.00) μmol/L during CNNHS 2010–2012. Compared with 2002, the vitamin A levels in the elderly across all region, gender and age groups showed an upward trend, with the difference being statistically significant (all P &lt; 0.05). In 2012, the incidence of VAD in the elderly participants was higher than in 2002 (3.39vs1.46) (P &lt; 0.001). However, the incidence of marginal VAD was lower than in 2002 (7.38vs8.62) (P = 0.019). VAD in those being large cities, small and medium-sized cities, rural area, male and female, aged 60–69 or 70–79 were higher than in 2002 (all P &lt; 0.05), poor rural areas was significantly lower than in 2002 (P &lt; 0.001). The prevalence of marginal VAD among the urban elderly in 2012 was higher than in 2002 (P &lt; 0.05), whereas the prevalence was lower than that in 2002 among the rural elderly (P &lt; 0.001). The prevalence of marginal VAD in the male elderly (P &lt; 0.001) and in the 60–69 age group (P = 0.014) were lower than in 2002. Conclusions Our findings showed that vitamin A status among elderly was greatly improved by 10 years, but VAD remains a public health problem in the Chinese elderly population. Therefore, reducing the incidence of VAD is crucial to the health of the elderly in China. In particular, attention needs to be paid to the nutrition and health status of urban and ≥80 year elderly. Funding Sources This research was supported by the Special Fund for Health-scientific Research in the Public Interest (No. 20,120,212) from the National Health and Family Planning Commission of the People's Republic of China.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
A. M. Hamdy ◽  
M. M. Abdel Aleem ◽  
A. A. El-Shazly

Background. Vitamin A deficiency (VAD) during pregnancy represents a major public health problem in developing countries. Anemia is a common consequence of VAD. We aimed to measure serum retinol concentrations of a sample of poor Egyptian mothers and correlate it with their Hb% and cord Hb%. Methods. This cross-sectional study included 200 healthy mothers and their healthy full term newborns. Maternal and cord blood samples were collected for CBC and measurement of serum retinol concentrations. Results. Forty-seven mothers (23.5%) had VAD and 50% were anemic. Mothers with VAD had a significantly lower mean Hb% and a significantly higher frequency of anemia (95.7%) compared to mothers without VAD (35.9%). The relative risk for anemia among mothers with VAD was 2.7 (CI = 2.12–3.3). Newborns of mothers with VAD had a significantly lower mean cord Hb% compared to newborns of mothers without VAD. Maternal serum retinol concentrations were positively correlated with maternal Hb% and cord Hb%. Conclusion. Maternal VAD during pregnancy among poor mothers is associated with maternal anemia and lower Hb% of newborns at birth. Vitamin A supplementation is highly recommended for this vulnerable group.


2006 ◽  
Vol 9 (8) ◽  
pp. 955-960 ◽  
Author(s):  
Jiang Jingxiong ◽  
André Michael Toschke ◽  
Rüdiger von Kries ◽  
Berthold Koletzko ◽  
Lin Liangming

AbstractObjectiveThe objective of this study was to assess the prevalence of vitamin A deficiency (VAD) in children under 6 years old in China and to identify risk groups for VAD.DesignA cross-sectional survey was conducted in 14 provinces from coastal, inland and western geographic areas in China.SettingOne city (urban) and two counties (rural) were randomly selected from each province as survey areas.SubjectsAbout 200 children aged 0–6 years were randomly selected in each survey area. A blood sample was collected from each child. Data on sociodemographics and nutrition were obtained by interview of the mother or principal caregiver. Fluorescence microanalysis was used to analyse serum retinol concentration.ResultsVAD (serum retinol < 0.7 μmol l− 1) was observed in 957 out of 7826 children aged 0–6 years (12.2% of the entire study population), whereas severe VAD (serum retinol < 0.35 μmol l− 1) was found in 39 children (0.5%). The highest prevalences of VAD at >1 year of age were observed among children of mothers with minority ethnicity (22.7%) or poor education (19.8%) and in the poor western area (17.4%).ConclusionsVAD is a nutritional problem in children in China. Children living in the poor western area, having a mother with minority ethnicity or a mother with poor education have a high risk of VAD.


2017 ◽  
Vol 8 (1) ◽  
pp. 52
Author(s):  
Ane B Fisker ◽  
Ted Greiner

High-dose vitamin A capsules (HDVAC) are distributed to preschool children in low-income countries on the assumption that they reduce mortality and treat vitamin A deficiency. As for other so-called magic bullet approaches, donors and policy makers consider their large-scale distribution highly cost-effective. Consequently, other ways to improve vitamin A status have received less attention; both donors and governments assume HDVAC are doing most of what needs to be done. Yet, the only evidence for an effect on mortality comes from 25-year-old studies and this effect no longer appears to be substantial. Surprisingly, impact evaluations have been absent. The only study that might be considered an effectiveness or impact evaluation found HDVAC had no effect in northern India. It is not widely appreciated that the impact of HDVAC on vitamin A status is limited, temporary and not cumulative over time. Nor can it be given to women except immediately after giving birth, and thus it is an inappropriate intervention for tackling vitamin A deficiency. To ensure that we use limited resources wisely, we need to identity and scale up strategies which combat vitamin A deficiency and reduce mortality.


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