Improving child survival through vitamin A supplementation

BMJ ◽  
2011 ◽  
Vol 343 (aug25 1) ◽  
pp. d5294-d5294 ◽  
Author(s):  
A. Thorne-Lyman ◽  
W. W. Fawzi
Keyword(s):  
Vitamin A ◽  
Child Survival ◽  
Vitamin A Supplementation

Coverage of the vitamin A supplementation programme for child survival in Nepal: success and challenges

2012 ◽  
Vol 32 (4) ◽  
pp. 233-238 ◽  
Author(s):  
A M Nguyen ◽  
D S Grover ◽  
K Sun ◽  
V K Raju ◽  
R D Semba ◽  
...  
Keyword(s):  
Vitamin A ◽  
Child Survival ◽  
Vitamin A Supplementation

scholarly journals Refocusing vitamin A supplementation programmes to reach the most vulnerable

2020 ◽  
Vol 5 (7) ◽  
pp. e001997
Author(s):  
Erin McLean ◽  
Rolf Klemm ◽  
Hamsa Subramaniam ◽  
Alison Greig
Keyword(s):  
Vitamin A ◽  
Child Mortality ◽  
Vitamin A Deficiency ◽  
Child Survival ◽  
Public Health Problem ◽  
Mortality Rates ◽  
Vitamin A Supplementation ◽  
Use Of Resources ◽  
Year 2000 ◽  
Programme Coverage

WHO recommends vitamin A supplementation (VAS) programmes for children 6–59 months where vitamin A deficiency is a public health problem. However, resources for VAS are falling short of current needs and programme coverage is suffering. The authors present the case for considering the options for shifting efforts and resources from a generalised approach, to prioritising resources to reach populations with continued high child mortality rates and high vitamin A deficiency prevalence to maximise child survival benefits . This includes evaluating where child mortality and/or vitamin A deficiency has dropped, as well as using under 5 mortality rates as a proxy for vitamin A deficiency, in the absence of recent data. The analysis supports that fewer countries may now need to prioritise VAS than in the year 2000, but that there are still a large number of countries that do. The authors also outline next steps for analysing options for improved targeting and cost-effectiveness of programmes. Focusing VAS resources to reach the most vulnerable is an efficient use of resources and will continue to promote young child survival.

Maternal Priming: Bacillus Calmette-Guérin (BCG) Vaccine Scarring in Mothers Enhances the Survival of Their Child With a BCG Vaccine Scar

2019 ◽  
Vol 9 (2) ◽  
pp. 166-172 ◽  
Author(s):  
Mike L T Berendsen ◽  
Christian Bjerregård Øland ◽  
Pauli Bles ◽  
Aksel Karl Georg Jensen ◽  
Poul-Erik Kofoed ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Vitamin A ◽  
Proportional Hazards Model ◽  
Controlled Trial ◽  
Child Survival ◽  
Cox Proportional Hazards Model ◽  
Bcg Vaccine ◽  
Lower Mortality ◽  
Bacillus Calmette Guerin ◽  
Vitamin A Supplementation

Abstract Background and Hypothesis Maternal priming might enhance the beneficial nonspecific effects (NSEs) of live measles vaccination (MV). Children with a bacillus Calmette-Guérin (BCG) vaccine scar have a lower mortality rate than those without a scar that is not explained by protection against tuberculosis. We examined the hypothesis that BCG scarring would have a stronger effect on a child if the mother also had a BCG scar. Methods In a randomized controlled trial (RCT) of early MV in children aged 4.5 months, the BCG-scar status of the children and their mother were registered at enrollment at 4.5 months of age. The children were followed up until they were 36 months of age. Using a Cox proportional hazards model, we compared mortality rate ratios according to maternal and child BCG-scar status after adjusting for where the BCG vaccine was given (the national hospital or elsewhere). We censored for other interventions that have immunomodulating effects on child survival, including neonatal vitamin A supplementation and early MV. Results A total of 2213 children had not received neonatal vitamin A supplementation and early MV; 83% of these children and 44% of the mothers had a BCG scar. Children whose mother had a BCG scar were not more likely to have a BCG scar than those whose mother did not have a BCG scar (risk ratio, 1.01 [95% confidence interval (CI), 0.98–1.05]). Among the children, having a BCG scar was associated with a 41% (95% CI, 5%–64%) lower mortality between the ages of 4.5 and 36 months. The reduction in mortality was 66% (95% CI, 33%–83%) if the mother also had a BCG scar but only 8% (95% CI, −83% to 53%) if the mother had no BCG scar (test of interaction, P = .04). Conclusions Maternal BCG priming might be important for the effect of BCG vaccination on child survival. Ensuring better BCG vaccine scarring among mothers and children could have a considerable effect on child mortality levels.

Heterogeneous effects on child survival in neonatal vitamin A supplementation trials – Authors' reply

The Lancet ◽  
2011 ◽  
Vol 377 (9774) ◽  
pp. 1315
Author(s):  
Betty Kirkwood ◽  
Jean Humphrey ◽  
Lawrence Moulton ◽  
Jose Martines
Keyword(s):  
Vitamin A ◽  
Child Survival ◽  
Vitamin A Supplementation ◽  
Heterogeneous Effects

scholarly journals Co-implementing Vitamin A supplementation with Seasonal Malaria Chemoprevention in Sokoto State, Nigeria: a feasibility and acceptability study

2021 ◽  
Author(s):  
Olusola Oresanya ◽  
Abimbola Phillips ◽  
Ekechi Okereke ◽  
Abraham Ahmadu ◽  
Taiwo Ibinaiye ◽  
...  
Keyword(s):  
Vitamin A ◽  
Child Survival ◽  
World Health ◽  
High Dose ◽  
Northern Nigeria ◽  
Vitamin A Supplementation ◽  
Seasonal Malaria Chemoprevention ◽  
Directly Observed Treatment ◽  
Health Organization ◽  
Community Drug Distributors

Abstract Background Bi-annual high dose vitamin A supplements administered to children aged 6-59 months can significantly reduce child mortality, but vitamin A supplementation (VAS) coverage is low in Nigeria. The World Health Organization recommends that VAS be integrated into other public health programmes which are aimed at improving child survival. Seasonal malaria chemoprevention (SMC) provides a ready platform for VAS integration to improve health outcomes. Methods A mixed methods study design was used to assess the feasibility and acceptability of co-implementing VAS with SMC in one local government area of Sokoto state in northern Nigeria. Existing SMC implementation tools and job aids were revised and community drug distributors, experienced in SMC delivery, were trained on the determination of VAS eligibility, administration of the correct doses and identification of adverse drug reactions. SMC and VAS were delivered using a door-to-door approach. VAS and SMC coverage were calculated and the outcome of the integration was assessed using questionnaires administered to 188 and 197 households at baseline and endline respectively. The Bowen framework was used to assess feasibility through focus group discussions and key informant interviews; thematic analysis was carried out on the qualitative data. Results At endline, the proportion of children who received at least one dose of VAS in the last six months increased significantly from 2–59% (p<0.001). There were no adverse effects on the coverage of SMC delivery with 70% eligible children reached at baseline, increasing to 76% (p=0.412) at endline. There was no significant change (p=0.264) in the quality of SMC, measured by proportion of children receiving their first dose as directly observed treatment (DOT), at endline (68%) compared to baseline (54%). Study findings demonstrated acceptability among caregivers, community drug distributors, State and National healthcare officials. Conclusion This study showed that it is feasible and acceptable to integrate VAS with SMC delivery in areas of high seasonal malaria transmission such as northern Nigeria, where SMC campaigns are implemented. SMC-VAS integrated campaign can significantly increase vitamin A coverage but more research is required to demonstrate the feasibility of this integration in different settings and on a larger scale.

Vitamin A supplementation and child survival

The Lancet ◽  
1992 ◽  
Vol 340 (8814) ◽  
pp. 267-271 ◽  
Author(s):  
M.G. Herrera ◽  
P. Nestel ◽  
L. Weld ◽  
A. El Amin ◽  
K.A. Mohamed ◽  
...  
Keyword(s):  
Vitamin A ◽  
Child Survival ◽  
Vitamin A Supplementation

scholarly journals Co-implementing Vitamin A supplementation with Seasonal Malaria Chemoprevention in Sokoto State, Nigeria: a feasibility and acceptability study

2021 ◽  
Author(s):  
Olusola Oresanya ◽  
Abimbola Phillips ◽  
Ekechi Okereke ◽  
Abraham Ahmadu ◽  
Taiwo Ibinaiye ◽  
...  
Keyword(s):  
Vitamin A ◽  
Child Survival ◽  
World Health ◽  
High Dose ◽  
Northern Nigeria ◽  
Vitamin A Supplementation ◽  
Seasonal Malaria Chemoprevention ◽  
Directly Observed Treatment ◽  
Health Organization ◽  
Community Drug Distributors

Abstract BackgroundBi-annual high dose vitamin A supplements administered to children aged 6-59 months can significantly reduce child mortality, but vitamin A supplementation (VAS) coverage is low in Nigeria. The World Health Organization recommends that VAS be integrated into other public health programmes which are aimed at improving child survival. Seasonal malaria chemoprevention (SMC) provides a ready platform for VAS integration to improve health outcomes.MethodsA mixed methods study design was used to assess the feasibility and acceptability of co-implementing VAS with SMC in one local government area of Sokoto state in northern Nigeria. Existing SMC implementation tools and job aids were revised and community drug distributors, experienced in SMC delivery, were trained on the determination of VAS eligibility, administration of the correct doses and identification of adverse drug reactions. SMC and VAS were delivered using a door-to-door approach. VAS and SMC coverage were calculated and the outcome of the integration was assessed using questionnaires administered to 188 and 197 households at baseline and endline respectively. The Bowen framework was used to assess feasibility through focus group discussions and key informant interviews; thematic analysis was carried out on the qualitative data. ResultsAt endline, the proportion of children who received at least one dose of VAS in the last six months increased significantly from 2% to 59% (p<0.001). There were no adverse effects on the coverage of SMC delivery with 70% eligible children reached at baseline, increasing to 76% (p=0.412) at endline. There was no significant change (p=0.264) in the quality of SMC, measured by proportion of children receiving their first dose as directly observed treatment (DOT), at endline (68%) compared to baseline (54%). Study findings demonstrated acceptability among caregivers, community drug distributors, State and National healthcare officials. ConclusionThis study showed that it is feasible and acceptable to integrate VAS with SMC delivery in areas of high seasonal malaria transmission such as northern Nigeria, where SMC campaigns are implemented. SMC-VAS integrated campaign can significantly increase vitamin A coverage but more research is required to demonstrate the feasibility of this integration in different settings and on a larger scale.

Heterogeneous effects on child survival in neonatal vitamin A supplementation trials

The Lancet ◽  
2011 ◽  
Vol 377 (9774) ◽  
pp. 1314-1315 ◽  
Author(s):  
Christine Stabell Benn ◽  
Ane Fisker ◽  
Peter Aaby
Keyword(s):  
Vitamin A ◽  
Child Survival ◽  
Vitamin A Supplementation ◽  
Heterogeneous Effects
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