scholarly journals Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children

2012 ◽  
Vol 108 (8) ◽  
pp. 1419-1427 ◽  
Author(s):  
Nguyen Trung Hieu ◽  
Fanny Sandalinas ◽  
Agnès de Sesmaisons ◽  
Arnaud Laillou ◽  
Nguyen Phuong Tam ◽  
...  

In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95 % CI 28·0, 55·4) μg/l; SUP: geometric mean 46·0 (95 % CI 33·0, 71·7) μg/l; C: geometric mean 34·4 (95 % CI 15·2, 51·2) μg/l; P < 0·001) and lower TfR concentrations (FB: geometric mean 5·7 (95 % CI 4·8, 6·52) mg/l; SUP: geometric mean 5·5 (95 % CI 4·9, 6·2) mg/l; C: geometric mean 5·9 (95 % CI 5·1, 7·1) mg/l; P = 0·007). Consequently, body Fe was higher in children receiving FB (mean 5·6 (sd 2·2) mg/kg body weight) and SUP (mean 6·1 (sd 2·5) mg/kg body weight) compared with the C group (mean 4·2 (sd 3·3) mg/kg body weight, P < 0·001). However, anaemia prevalence was significantly lower only in the FB group (1·0 %) compared with the C group (10·4 %, P = 0·006), with the SUP group being intermediate (7·4 %). Children receiving FB had better weight-for-height Z-scores after the intervention than children receiving the SUP (P = 0·009). Vitamin A deficiency at baseline modified the intervention effect, with higher Hb concentrations in vitamin A-deficient children receiving FB but not in those receiving the SUP. This indicates that vitamin A deficiency is implicated in the high prevalence of anaemia in Vietnamese school children, and that interventions should take other deficiencies besides Fe into account to improve Hb concentrations. Provision of biscuits fortified with multiple micronutrients is effective in reducing anaemia prevalence in school children.

2014 ◽  
Vol 27 (3) ◽  
pp. 301-310 ◽  
Author(s):  
Dixis Figueroa Pedraza ◽  
Márcia Cristina Sales

OBJECTIVE: To estimate the isolated and combined prevalence of anemia, vitamin A deficiency and zinc deficiency in pre-school children, as well as the distribution of isolated deficiencies according to gender, age and prior supplementation with vitamin A. METHODS: Cross-sectional study with pre-school children in the state of Paraíba, Brazil. Analysis of the average concentrations of hemoglobin, serum retinol and serum zinc, according to gender, age and previous vitamin A supplementation of children were carried out as well as the risk of simultaneous occurrence of micronutrient deficiencies in the presence of these deficiencies. RESULTS: The prevalence of anemia, vitamin A deficiency and zinc deficiency were 15.4%, 23.3% and 13.8%, respectively. The anemia was significantly associated with age (p<0.01). Children previously supplemented by vitamin A had higher serum retinol concentrations than children without supplements, an effect that was not observed for concentrations of hemoglobin or serum zinc. The prevalence of anemia associated with vitamin A deficiency was 5.8%, with the chance of vitamin A deficiency and anemia coexist 2.21 times (95%CI=1.03-4.84) higher in the case of vitamin A deficiency or anemia rather than in the absence of these conditions. CONCLUSION: The high prevalence of micronutrient deficiencies which are important in child growth, as well as the coexistence of nutritional deficiencies, point out the need to strengthen nutrition intervention strategies that consider this issue.


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.


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


2016 ◽  
Vol 115 (8) ◽  
pp. 1415-1423 ◽  
Author(s):  
Ke Chen ◽  
Hu Mina Xie ◽  
Weizheng Tian ◽  
Xiaoling Zheng ◽  
Alice C. Jiang

AbstractThe aim of this study was to explore the effect of single-dose albendazole and vitamin A intervention on the anaemic status and Fe metabolism of pre-school children. This study was a randomised, placebo-controlled and double-blinded intervention trial. All eligible anaemic pre-school children were randomly divided into three groups: group 1 received no intervention, which served as the control group, group 2 received 400 mg single-dose albendazole administration and group 3 received a 60000 μg vitamin A capsule combined with 400 mg single-dose albendazole at the beginning of the study. The follow-up period was for 6 months. Anthropometry and biochemical index about Fe metabolism were measured before and after intervention. A total of 209 pre-school anaemic children were randomly divided into three intervention groups (sixty-four, sixty-two and sixty for groups 1, 2 and 3, respectively). The mean age of the children in the study was 4·4 (sd 0·7) years and 50·5 % of the children were female (94/186). After a follow-up period of 6 months, the levels of serum retinol, ferritin, transferrin receptor-ferritin index and body total Fe content of children in group 3 were significantly higher compared with children in groups 1 and 2 (P<0·05). Moreover, the proportion of vitamin A deficiency, marginal vitamin A deficiency and Fe deficiency among children in group 3 were markedly lower compared with children in groups 1 and 2 (P<0·05). Albendazole plus vitamin A administration showed more efficacy on the improvement of serum retinol and Fe metabolic status.


2010 ◽  
Vol 13 (11) ◽  
pp. 1863-1869 ◽  
Author(s):  
Nguyen Cong Khan ◽  
Phan Van Huan ◽  
Nguyen Van Nhien ◽  
Le Danh Tuyen ◽  
Saskia de Pee ◽  
...  

AbstractObjectiveTo characterize the relationship between serum carotenoids, retinol and anaemia among pre-school children.DesignA cross-sectional study was conducted in two groups: anaemic and non-anaemic. Serum levels of retinol, α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin were measured in the study subjects.SettingSix rural communes of Dinh Hoa, a rural and mountainous district in Thai Nguyen Province, in the northern mountainous region of Vietnam.SubjectsA total of 682 pre-school children, aged 12–72 months, were recruited.ResultsGeometric mean serum concentrations of carotenoids (μmol/l) were 0·056 for α-carotene, 0·161 for β-carotene, 0·145 for β-cryptoxanthin, 0·078 for lycopene, 0·388 for lutein and 0·075 for zeaxanthin. The mean levels of Hb and serum retinol were 108·8 g/l and 1·02 μmol/l, respectively. The prevalence of anaemia and vitamin A deficiency was 53·7 % and 7·8 %, respectively. After adjusting for sex and stunting, serum retinol concentrations (μmol/l; OR = 2·06, 95 % CI 1·10, 3·86, P = 0·024) and total provitamin A carotenoids (μmol/l; OR = 1·52, 95 % CI 1·01, 2·28, P = 0·046) were independently associated with anaemia, but non-provitamin A carotenoids (μmol/l; OR = 0·93, 95 % CI 0·63, 1·37, P = 0·710) were not associated with anaemia.ConclusionsAmong pre-school children in the northern mountainous region of Vietnam, the prevalences of vitamin A deficiency and anaemia are high, and serum retinol and provitamin A carotenoids are independently associated with anaemia. Further studies are needed to determine if increased consumption of provitamin A carotenoids will reduce anaemia among pre-school children.


2019 ◽  
Vol 89 (5-6) ◽  
pp. 321-330 ◽  
Author(s):  
Sobhana Ranjan ◽  
Santosh J. Passi ◽  
Som N. Singh

Abstract. Objectives: Food-based strategies remain the most sustainable solutions for combating micronutrient deficiencies. Crude palm oil being the richest natural source of β-carotene, the study aimed to assess the impact of crude palm oil fortified cookies supplementation on anthropometry, vitamin A and hematological status of school children. Methods: 444 children (boys-226, girls-218), aged 5-13 years from two Municipal Corporation of Delhi primary schools were enrolled. By draw of lot, children from one of the schools formed the experimental (n = 224; boys-119, girls-105) while other formed the placebo group (n = 220; boys-107; girls-113). Children from the experimental group received six crude palm oil fortified cookies providing 2152 μg of β-carotene while the placebo group received similar but non-fortified cookies each day for 50 school days. Anthropometry, vitamin A, and hematological status were assessed at baseline and post supplementation. Results: Post supplementation, the number of stunted subjects reduced significantly (p < 0.05) in the experimental group. There was a significant increase in plasma retinol (170.9%; mean change: 1.55 ± 1.30 μmol/L - experimental group vs. 0.45 ± 0.99 μmol/L - placebo group) and β-carotene (p < 0.01; median change from 0.55 to 0.76 μmol/L - experimental group vs. 0.59 to 0.55 μmol/L -placebo group) concentrations of the experimental group. The increase in hematological parameters (mean change in Hemoglobin: 1.64 g/dL in experimental group vs. 2.10 g/dL in placebo group) of both the groups were however, comparable. Conclusion: To address micronutrient deficiencies particularly in developing nations, the use of crude palm oil should be encouraged through supplementary feeding programs by way of ready-to-eat snacks.


2021 ◽  
Vol 42 (1) ◽  
pp. 133-154
Author(s):  
Joanne E. Arsenault ◽  
Deanna K. Olney

Background: Rwanda’s commitment to reducing malnutrition is evident in their multisectoral nutrition policy and wide array of nutrition partners. However, the prevalence of micronutrient deficiencies and the suitability of current strategies to address existing deficiencies is unclear. Objective: To review the available evidence related to the prevalence of micronutrient deficiencies across the life cycle and strategies in place to address them. Methods: We reviewed scientific and grey literature on nutritional problems in Rwanda, emphasizing micronutrient deficiencies and anemia, and current strategies to address micronutrient malnutrition. Results: Overall, there is scant evidence related to the types and prevalence of micronutrient deficiencies among populations across the life cycle in Rwanda. Existing evidence is primarily limited to outdated or small regional surveys focusing on iron or vitamin A among women and young children. Surveys have assessed the prevalence of anemia and indicate that anemia is very high among young children and moderately high among other age-groups. However, there are limited data on the context-specific causes of anemia in Rwanda across population groups. Current nutrition strategies mainly target women and young children and are primarily designed to reduce vitamin A deficiency and/or anemia caused by micronutrient deficiencies. Conclusions: Rwanda has many nutrition programs in place that address micronutrient deficiencies in young children and a few for women of reproductive age. However, gaps exist in knowledge of the extent of different types of micronutrient deficiencies among all populations across the life cycle and whether the delivery of nutrients through current programs is meeting actual needs.


2018 ◽  
Vol 104 (3) ◽  
pp. 217-226 ◽  
Author(s):  

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.


Author(s):  
Sunil Pal Singh Chajhlana ◽  
Ramakrishna Narashimha Mahabhasyam ◽  
Maruti Sarma Mannava Varaprasada

Background: The school age period is nutritionally significant because this is the prime time to build up body stores of nutrients in preparation for rapid growth of adolescence. Malnutrition remains the world’s most serious health problem and the single biggest contributor to child mortality, nearly one third of the children in the developing world are either underweight or stunted and more than 30% of the developing world’s population suffer from micronutrient deficiencies. However the data available from urban slums of Hyderabad in this age group is very sparse and hence an attempt has been made to study the same. The objectives were to determine the nutritional status of primary school children and study the factors associated with it.Methods:Study population:  Primary school children (6 to 11 years). Study area: primary schools in urban slums of Hyderabad. Study design: a cross sectional study. Sample size: 412 children. Sampling methods:  Simple random sampling Data collection: By using pre designed and pre tested and pre coded schedule (interview technique, observation, clinical examination). Analysis: By using Microsoft Excel 2007 and Epi Info 3.5.3.Results: The prevalence of underweight was 28.9%, overweight was 9.2% and obesity was 4.4% . Prevalence of stunted height was found among 21.8%. 5.8% children were suffering from Vitamin’ A’ deficiency, 15.0% were suffering from Vitamin B deficiency, and 15.8% were found to be anemic.Conclusions:The prevalence of underweight, Nutritional deficiencies were found to be significantly higher in children of illiterate parents’ and similarly in unskilled worker fathers’ and unemployed mothers. 


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