Vitamin A supplementation ameliorates motor incoordination via modulating RORα in the cerebellum in a valproic acid-treated rat autism model with vitamin A deficiency

Vitamin A deficiency resulting from inadequate intake or induced by infection is associated with increased morbidity and mortality. Measles, the major single infectious cause of mortality in children worldwide, is more severe in children who have preexisting vitamin A deficiency. Several recent studies suggest that: 1) measles is associated with depressed serum levels of vitamin A; 2) hyporetinemia, defined as a serum retinol of less than 0.7 µmol/L, is associated with increased mortality from measles, especially in children younger than 2 years of age; and 3) vitamin A will decrease the risk of complications and death when administered during the acute phase of illness (within 5 days of the onset of rash).

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Early neonatal vitamin A supplementation and infant mortality: an individual participant data meta-analysis of randomised controlled trials

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-315242 ◽

2018 ◽

Vol 104 (3) ◽

pp. 217-226 ◽

Cited By ~ 8

Author(s):

Keyword(s):

Infant Mortality ◽

Vitamin A ◽

Maternal Education ◽

Vitamin A Deficiency ◽

Population Characteristics ◽

Infant Survival ◽

Vitamin A Supplementation ◽

Maternal Vitamin ◽

Early Infant ◽

The Impact

BackgroundBiannual vitamin A supplementation is a well-established survival tool for preschool children 6 months and older in vitamin A deficient populations but this schedule misses the opportunity to intervene on most young infant deaths. Randomised trials of neonatal vitamin A supplementation (NVAS) in the first few days of life to assess its impact on under 6-month mortality in low/middle-income countries have had varying results.MethodsInvestigators of 11 published randomised placebo-controlled NVAS trials (n=163 567 children) reanalysed their data according to an agreed plan and pooled the primary outcomes of mortality from supplementation through 6 and 12 months of age using random effects models and meta-regression. One investigator withdrew but allowed use of the data.FindingsOverall there was no effect of NVAS on infant survival through 6 (risk ratio (RR) 0.97; 95% CI 0.89 to 1.06) or 12 months of age (RR 1.00; 95% CI 0.93 to 1.08) but results varied by study population characteristics.NVAS significantly reduced 6-month mortality among the trials conducted in Southern Asia (RR 0.87; 95% CI 0.77 to 0.98), in contexts with moderate or severe vitamin A deficiency (defined as 10% or higher proportion of women with serum retinol <0.7 µmol/L or 5% or more women with night blindness) (RR 0.87; 95% CI 0.80 to 0.94), early infant mortality was 30 or more per 1000 live births (RR 0.91; 95% CI 0.85 to 0.98), 75% or more of infant mortality occurred in the first 6 months of life (RR 0.92; 95% CI 0.84 to 1.01), or where >32% mothers had no schooling (RR 0.88; 95% CI 0.80 to 0.96). NVAS did not reduce mortality in the first 6 months of life in trials conducted in Africa, in contexts characterised by a low prevalence of vitamin A deficiency, lower rates of infant mortality and where maternal education was more prevalent. There was a suggestion of increased infant mortality in trials conducted in Africa (RR 1.07; 95% CI 1.00 to 1.15).Individual-level characteristics such as sex, birth weight, gestational age and size, age at dosing, parity, time of breast feeding initiation, maternal education and maternal vitamin A supplementation did not modify the impact of NVAS.ConclusionNVAS reduced infant mortality in South Asia, in contexts where the prevalence of maternal vitamin A deficiency is moderate to severe and early infant mortality is high; but it had no beneficial effect on infant survival in Africa, in contexts where the prevalence of maternal vitamin A deficiency is lower, early infant mortality is low.

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Effect of vitamin A on severity of acute diarrhea in children

Paediatrica Indonesiana ◽

10.14238/pi53.3.2013.125-31 ◽

2013 ◽

Vol 53 (3) ◽

pp. 125

Author(s):

Marlisye Marpaung ◽

Supriatmo Supriatmo ◽

Atan Baas Sinuhaji

Keyword(s):

Vitamin A ◽

Acute Diarrhea ◽

Vitamin A Deficiency ◽

Stool Consistency ◽

Chi Square ◽

Vitamin A Supplementation ◽

Body Weights ◽

Group 2 ◽

Stool Volume ◽

Group 1

Background Vitamin A deficiency may increase the risk or bea cause of diarrhea. Many studies have been conducted on theefficacy of vitamin A in the management of acute diarrhea, butthe outcomes remain inconclusive.Objective To determine the effectiveness of vitamin A in reducingthe severity of acute diarrhea in children.Methods We performed a single􀁈blind􀁈randomized controlledtrial in the Secanggang District, Langkat Regency, North ofSumatera, from August 2009 to January 2010 in children aged6 months to 5 years, who had diarrheas. Subjects were dividedinto two groups. Group 1 received a single dose of vitamin A(100,000 IU for subjects aged 6 to 11 month old or with bodyweights :s 10 kg, or 200,000 IU for subjects aged 2: 12 month oldor with body weights> 10 kg). Group 2 received a single doseof placebo. The establishment of severity was based on changesin diarrheal frequency, stool consistency, volume and durationof diarrhea after treatment. We performed independent T􀁈testand Chi square tests for statistical analyses. The study was anintention􀁈to􀁈treat analysis.Results We enrolled 120 children who were randomized intotwo groups of 60 subjects each. Group 1, received vitamin Aand group 2 received a placebo. The results showed significantdifferences between the two groups in stool volume starting onthe first day (95%CI 192.30 to 3237.51; P􀁉O.OOI), as well asdiarrheal frequency (P=O.OOl) and stool consistency (P=O.OOl)on the second day observation and duration of diarrhea followingtreatment (95%CI - 40.60 to - 25.79; P􀁉O.OOI;).Conclusions Vitamin A supplementation is effective in reducingthe severity of acute diarrhea in children under five years of age.[Paediatr lndones. 2013;53:125-31.]

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The Effect of Oral Vitamin A Supplementation on Chalazion in Young Children with Vitamin A Deficiency: A Pilot Study

Journal of Ocular Pharmacology and Therapeutics ◽

10.1089/jop.2020.0115 ◽

2021 ◽

Author(s):

Xu Gao ◽

Qin Xiang ◽

Jing Fang

Keyword(s):

Pilot Study ◽

Young Children ◽

Vitamin A ◽

Vitamin A Deficiency ◽

Oral Vitamin ◽

Vitamin A Supplementation

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Uptake of routine vitamin A supplementation for children in Humbo district, southern Ethiopia: community-based cross-sectional study

BMC Public Health ◽

10.1186/s12889-020-09617-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Getnet Kassa ◽

Addisalem Mesfin ◽

Samson Gebremedhin

Keyword(s):

Preschool Children ◽

Vitamin A ◽

Vitamin A Deficiency ◽

Economic Status ◽

Cross Sectional Study ◽

Southern Ethiopia ◽

Sectional Study ◽

Cross Sectional ◽

Vitamin A Supplementation ◽

Socio Economic Status

Abstract Background In low- and middle-income countries routine vitamin A supplementation (VAS) is a key strategy for reducing vitamin A deficiency and mortality and morbidity of preschool children. However, in Ethiopia, there is paucity of evidence regarding the level and determinants of the uptake of the supplement. This study was designed to assess the coverage and predictors of VAS among preschool children in Humbo district, Southern Ethiopia. Methods A cross-sectional study was conducted in April 2016. A total of 840 mothers/caregivers having children 6–59 months of age were selected using multistage cluster sampling technique from six rural villages implementing routine VAS program. Data were collected using interviewer administered questionnaire. Possible predictors considered in the study include distance from the nearby health facility, household socio-economic status, type of the household (model vs non-model), maternal access to health education on VAS, and knowledge on vitamin A and VAS. Multivariable logistic regression analysis was performed to identify predictors of uptake of VAS. The outputs are presented using adjusted odds ratio (AOR) with the respective 95% confidence interval (CI). Results The coverage of VAS was 75.0% (95% CI: 72.1–77.9). Better knowledge of mothers about the importance of the supplement (AOR: 1.49, 1.02–2.17), obtaining VAS related information from frontline community health workers (AOR: 1.51, 1.34–2.72) than health professionals and being from households in the “rich” wealth tertile (AOR: 1.80, 95% CI: 1.07–3.03) were positively associated with uptake VAS. Conclusion The VAS coverage of the area was approaching the expected national target of 80%. However, the uptake can be enhanced though awareness creation and improving socio-economic status of the community.

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Refocusing vitamin A supplementation programmes to reach the most vulnerable

BMJ Global Health ◽

10.1136/bmjgh-2019-001997 ◽

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.

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Vitamin A deficiency among children younger than 5 y in India: an analysis of national data sets to reflect on the need for vitamin A supplementation

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa314 ◽

2020 ◽

Author(s):

G Bhanuprakash Reddy ◽

Raghu Pullakhandam ◽

Santu Ghosh ◽

Naveen K Boiroju ◽

Shalini Tattari ◽

...

Keyword(s):

Vitamin A ◽

Vitamin A Deficiency ◽

Public Health Problem ◽

Sample Survey ◽

Dietary Vitamin ◽

High Dose ◽

Serum Retinol ◽

Indian Children ◽

Vitamin A Supplementation ◽

National Prevalence

ABSTRACT Background Biochemical vitamin A deficiency (VAD) is believed to be a serious public health problem (low serum retinol prevalence >20%) in Indian children, justifying universal high-dose vitamin A supplementation (VAS). Objective To evaluate in Indian children younger than 5 y the risk of biochemical VAD from the Comprehensive National Nutrition Survey, as well as dietary vitamin A inadequacy and excess over the tolerable upper limit of intake (TUL) from national and subnational surveys, factoring in fortification and VAS. Methods Child serum retinol data, corrected for inflammation, were examined to evaluate national- and state-level prevalence of VAD. Simultaneously, dietary intakes from the National Sample Survey Office and the National Nutrition Monitoring Bureau were examined for risk of dietary vitamin A deficiency against its average requirement (AR) derived for Indian children. Theoretical estimates of risk reduction with oil and milk vitamin A fortification were evaluated along with the risk of exceeding the TUL, as well as when combined with intake from VAS. Results The national prevalence of biochemical VAD measured in 9563 children was 15.7% (95% CI: 15.2%, 16.3%), and only 3 states had prevalence significantly >20%. The AR of vitamin A was 198 and 191 µg/d for boys and girls; the risk of dietary inadequacy was ∼70%, which reduced to 25% with oil and milk fortification. Then, the risk of exceeding the TUL was 2% and 1% in 1- to 3-y-old and 4- to 5-y-old children, respectively, but when the VAS dose was added to this intake in a cumulative 6-mo framework, the risk of exceeding the TUL rose to 30% and 8%, respectively. Conclusion The national prevalence of VAD risk is below 20% in Indian children. Because there is risk of excess intake with food fortification and VAS, serious consideration should be given to a targeted approach in place of the universal VAS program in India.

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The National Vitamin A Supplementation Program and Subclinical Vitamin A Deficiency among Preschool Children in the Philippines

Food and Nutrition Bulletin ◽

10.1177/156482650402500401 ◽

2004 ◽

Vol 25 (4) ◽

pp. 319-329 ◽

Cited By ~ 24

Author(s):

M. R. A. Pedro ◽

J. R. Madriaga ◽

C. V. C. Barba ◽

R. C. F. Habito ◽

A. E. Gana ◽

...

Keyword(s):

Preschool Children ◽

Vitamin A ◽

Vitamin A Deficiency ◽

The Philippines ◽

Vitamin A Supplementation ◽

Subclinical Vitamin

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Resolution of Bitot's spots following mega-dose vitamin A supplementation in children between 1 and 5 years of age

Public Health Nutrition ◽

10.1017/s1368980013001584 ◽

2013 ◽

Vol 17 (7) ◽

pp. 1614-1619 ◽

Cited By ~ 3

Author(s):

Umesh Kapil ◽

Shraddha Dwivedi ◽

Harshpal S Sachdev ◽

SN Dwivedi ◽

RM Pandey ◽

...

Keyword(s):

Vitamin A ◽

Vitamin A Deficiency ◽

Indian Subcontinent ◽

Uttar Pradesh ◽

Clinical Predictors ◽

Vitamin A Supplementation ◽

Public Health Burden ◽

Predictors Of Response ◽

Before And After

AbstractObjectiveThe prevalence of Bitot's spots (BS) is often used to quantify vitamin A deficiency burden in India, both before and after mega-dose vitamin A supplementation (MVAS) programmes. However, the proportion of BS cured following this intervention is unclear in contemporary times. The current study evaluated the responsiveness of BS over 1 year to MVAS administered as per the national programme in rural India.DesignProspective, community-based, 1-year follow-up of a cohort.SettingRural Uttar Pradesh, India.SubjectsTwo hundred and sixty-two children with BS, aged between 1 and 5 years, administered 60 mg (retinol equivalent) of vitamin A on diagnosis and after 1 month. Cure or resolution was defined if there was no discernible BS in either eye.ResultsDuring 1 year, only three children were lost to follow-up. At 6 months of follow-up (MVAS at baseline and 1 month later), 51·1 (95% CI 45·3, 57·3) % were classified as cured. The corresponding figure at 1 year (additional MVAS at 6 months) was 59·9 (95% CI 54·1, 65·9) %. Among those cured at 6 months, about half and three-quarters had resolved at 2 and 3 months, respectively. Apart from male gender, there were no significant sociodemographic or clinical predictors of response.ConclusionsSubstantial non-response to MVAS at 6 months (49%) and 1 year (40%) of follow-up suggests that presently in the Indian subcontinent, BS is a relatively crude indicator of severe current vitamin A deficiency. For programmatic decisions and evaluation, the public health burden of vitamin A deficiency should not be assessed solely through BS.

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