scholarly journals Estimating the impact of vitamin A-fortified vegetable oil in Bangladesh in the absence of dietary assessment data

2014 ◽  
Vol 18 (3) ◽  
pp. 414-420 ◽  
Author(s):  
John L Fiedler ◽  
Keith Lividini ◽  
Odilia I Bermudez

AbstractObjectiveVitamin A deficiency is a serious health problem in Bangladesh. The 2011–12 Bangladesh Micronutrient Survey found 76·8 % of children of pre-school age were vitamin A deficient. In the absence of nationally representative, individual dietary assessment data, we use an alternative – household income and expenditure survey data – to estimate the potential impact of the introduction of vitamin A-fortified vegetable oil in Bangladesh.DesignItems in the household income and expenditure survey were matched to food composition tables to estimate households’ usual vitamin A intakes. Then, assuming (i) the intra-household distribution of food is in direct proportion to household members’ share of the household’s total adult male consumption equivalents, (ii) all vegetable oil that is made from other-than mustard seed and that is purchased is fortifiable and (iii) oil fortification standards are implemented, we modelled the additional vitamin A intake due to the new fortification initiative.SettingNationwide in Bangladesh.SubjectsA weighted sample of 12240 households comprised of 55580 individuals.ResultsNinety-nine per cent of the Bangladesh population consumes vegetable oil. The quantities consumed are sufficiently large and, varying little by socio-economic status, are able to provide an important, large-scale impact. At full implementation, vegetable oil fortification will reduce the number of persons with inadequate vitamin A intake from 115 million to 86 million and decrease the prevalence of inadequate vitamin A intake from 80 % to 60 %.ConclusionsVegetable oil is an ideal fortification vehicle in Bangladesh. Its fortification with vitamin A is an important public health intervention.

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.


2017 ◽  
Vol 13 (10) ◽  
pp. S200-S201
Author(s):  
Anahita Jalilvand ◽  
Andrew Suzo ◽  
Kejal Shah ◽  
Bradley Needleman ◽  
Sabrena Noria

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.


1994 ◽  
Vol 14 (3) ◽  
pp. 325-336 ◽  
Author(s):  
Somluk Nimsakul ◽  
Martine Collumbien ◽  
Vimolphan Likit-Ekaraj ◽  
Chunmet Suwanarach ◽  
Antika Tansuhaj ◽  
...  

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


2017 ◽  
Author(s):  
Omowunmi Aibana ◽  
Molly F. Franke ◽  
Chuan-Chin Huang ◽  
Jerome T. Galea ◽  
Roger Calderon ◽  
...  

AbstractBackgroundLow and deficient levels of vitamin A are common in low and middle income countries where tuberculosis burden is high. We assessed the impact of baseline levels of vitamins A and carotenoids on TB disease risk.Methods and FindingsWe conducted a case-control study nested within a longitudinal cohort of household contacts of pulmonary TB cases in Lima, Peru. We screened all contacts for TB disease at 2, 6, and 12 months after enrollment. We defined cases as HIV-negative household contacts with blood samples who developed TB disease at least 15 days after enrollment of the index patient. For each case, we randomly selected 4 controls from among contacts who did not develop TB disease, matching on gender and year of age. We used conditional logistic regression to estimate odds ratios (ORs) for incident TB disease by vitamin A and carotenoids levels, controlling for other nutritional and socioeconomic factors.Among 6751 HIV-negative household contacts with baseline blood samples, 192 developed secondary TB disease during follow-up. We analyzed 180 cases with viable samples and 709 matched controls. After controlling for possible confounders, we found that baseline vitamin A deficiency was associated with a 10-fold increase in risk of TB disease among household contacts (aOR 10.42; 95% CI 4.01–27.05; p < 0.001). This association was dose-dependent with stepwise increases in TB disease risk with each decreasing quartile of vitamin A level. Carotenoid levels were also inversely associated with TB risk among adolescents.Our study is limited by the one year duration of follow up and by the relatively few blood samples available from household contacts under ten years of age.ConclusionsVitamin A deficiency strongly predicted risk of incident TB disease among household contacts of TB patients. Vitamin A supplementation among individuals at high risk of TB may provide an effective means of preventing TB disease.


Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1286 ◽  
Author(s):  
Corrine Hanson ◽  
Elizabeth Lyden ◽  
Ann Anderson-Berry ◽  
Nicholas Kocmich ◽  
Amy Rezac ◽  
...  

Vitamin A is an essential nutrient in pregnancy, and other carotenoids have been independently associated with maternal-infant outcomes. The objective of this study was to quantify the status of vitamin A and carotenoids in Nigerian maternal-infant pairs at delivery, compare these to a cohort from a developed nation, and determine the impact on clinical outcomes. Maternal and cord blood samples were collected in 99 Nigerian mother-infant pairs. Concentrations of lutein + zeaxanthin, β-cryptoxanthin, lycopene, α- and β-carotenes, and retinol were measured using HPLC. Descriptive statistics were calculated and Spearman coefficients were used to assess correlations between maternal and cord measurements; Mann-Whitney tests were used to compare median plasma values between dichotomous variables. Linear regression models were used to adjust for relevant confounders. A p < 0.05 was considered statistically significant. Thirty-five percent of mothers had plasma retinol concentrations ≤0.70 µmol/L; 82% of infants had plasma retinol concentrations ≤0.70 µmol/L at delivery. Maternal and infant concentrations of vitamin A compounds were highly correlated and were associated with newborn growth and Apgar scores. Despite plasma concentrations of pro-vitamin A carotenoids higher than those reported in other populations, pregnant Nigerian women have a high prevalence of vitamin A deficiency. As vitamin A related compounds are modifiable by diet, future research determining the clinical impact of these compounds is warranted.


1993 ◽  
Vol 32 (4II) ◽  
pp. 699-711 ◽  
Author(s):  
Sohail J. Malik ◽  
Naeem Sarwar

It is argued generally that the observed pattern of use of remittances! by emigrant families reduces their effectiveness for economic development and growth. A large school of thought believes that a considerable portion of the remittance money is spent on raising current consumption, in making unproductive investment in real estate such as residential houses, and in acquiring consumer durables, etc. Such expenditure, apart from being inflationary in nature, also has a strong demonstration effect on the consumption patterns of families that do not receive remittances. Another aspect of the alleged consumption-oriented use of remittances is the relatively high import content of the consumption demand generated by remitted funds. This has the adverse implication of offsetting some of the balance of payments gains. There is, therefore, a need to critically examine the utilisation pattern of remittances in terms of statistically testing for differences in consumption behaviour between households that receive remittances and those that do not. This study attempts such an analysis based on the data from the Household Income and Expenditure Survey of 1987-88.


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