The impact of vitamin A supplementation given during a pneumonia episode on the subsequent morbidity of children

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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Vitamin A supplementation in Tanzania: the impact of a change in programmatic delivery strategy on coverage

BMC Health Services Research ◽

10.1186/1472-6963-6-142 ◽

2006 ◽

Vol 6 (1) ◽

Cited By ~ 8

Author(s):

Honorati Masanja ◽

Joanna Armstrong Schellenberg ◽

Hassan M Mshinda ◽

Meera Shekar ◽

Joseph KL Mugyabuso ◽

...

Keyword(s):

Vitamin A ◽

Vitamin A Supplementation ◽

Delivery Strategy ◽

The Impact

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Impact of vitamin A supplementation in anaemia during pregnancy: a randomized double blind controlled clinical trial

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182332 ◽

2018 ◽

Vol 7 (6) ◽

pp. 2262

Author(s):

Shakun Singh ◽

Rachna Chaudhary ◽

Vandana Dhama ◽

Anu Singh ◽

Urmila Karya

Keyword(s):

Clinical Trial ◽

Vitamin A ◽

Pregnant Women ◽

Controlled Clinical Trial ◽

Double Blind ◽

Vitamin A Supplementation ◽

Elemental Iron ◽

Group A ◽

Group B ◽

The Impact

Background: To study the impact of Vitamin A supplementation in anaemia during Pregnancy and thus improving maternal and fetal outcome a Randomized double blind controlled clinical trial was conducted in Department of Obstetrics and Gynaecology, L.L.R.M. Medical college Meerut involving 250 pregnant women in late pregnancy 18-28 weeks with haemoglobin levels <11 g% (7-11 g%)..Methods: The study subjects were divided into two groups: Group A (n=125): Received daily supplement containing Iron (60 mg elemental iron) + Folate (500 mcg) + Vitamin A 20,000 IU weekly for a minimum of 12 weeks. Group B (n=125): Received daily supplement containing iron (60 mg elemental iron) + Folate (500 mcg) for a minimum of 12 weeks.Results: Maximum patients were uneducated belonging to low socioeconomic status. The mean haemoglobin values in Group A and Group B increased from 9.674±1.05 and 9.53±1.04 to 12.2±0.89 and 10.82±1.06 respectively after supplementation. Similarily Serum Ferritin levels increased from 15.96±2.94 and 15.70±2.83 to 78.40±17.82 and 58.64±11.93. Mean corpuscular volume, packed cell volume and red blood cell counts also increased significantly. Maximum haemoglobin levels were achieved with both vitamin A and iron supplementation. The proportion of women who became non anaemic was 97.17% in Group A vs 68.69% in Group B.Conclusions: Vitamin A supplementation improves anaemia and also dramatically improves iron stores in anaemic pregnant women.

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Ending malnutrition in all its forms requires scaling up proven nutrition interventions and much more: a 129-country analysis

BMC Medicine ◽

10.1186/s12916-020-01786-5 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Nick Scott ◽

Dominic Delport ◽

Samuel Hainsworth ◽

Ruth Pearson ◽

Christopher Morgan ◽

...

Keyword(s):

Cost Effectiveness ◽

Vitamin A ◽

Pregnant Women ◽

Cost Effective ◽

Scaling Up ◽

Folic Acid Supplementation ◽

Nutrition Interventions ◽

Vitamin A Supplementation ◽

The Impact ◽

Total Impact

Abstract Background Sustainable Development Goal (SDG) 2.2 calls for an end to all forms of malnutrition, with 2025 targets of a 40% reduction in stunting (relative to 2012), for wasting to occur in less than 5% of children, and for a 50% reduction in anaemia in women (15–49 years). We assessed the likelihood of countries reaching these targets by scaling up proven interventions and identified priority interventions, based on cost-effectiveness. Methods For 129 countries, the Optima Nutrition model was used to compare 2019–2030 nutrition outcomes between a status quo (maintained intervention coverage) scenario and a scenario where outcome-specific interventions were scaled up to 95% coverage over 5 years. The average cost-effectiveness of each intervention was calculated as it was added to an expanding package of interventions. Results Of the 129 countries modelled, 46 (36%), 66 (51%) and 0 (0%) were on track to achieve the stunting, wasting and anaemia targets respectively. Scaling up 18 nutrition interventions increased the number of countries reaching the SDG 2.2 targets to 50 (39%), 83 (64%) and 7 (5%) respectively. Intermittent preventative treatment of malaria during pregnancy (IPTp), infant and young child feeding education, vitamin A supplementation and lipid-based nutrition supplements for children produced 88% of the total impact on stunting, with average costs per case averted of US$103, US$267, US$556 and US$1795 when interventions were consecutively scaled up, respectively. Vitamin A supplementation and cash transfers produced 100% of the total global impact on prevention of wasting, with average costs per case averted of US$1989 and US$19,427, respectively. IPTp, iron and folic acid supplementation for non-pregnant women, and multiple micronutrient supplementation for pregnant women produced 85% of the total impact on anaemia prevalence, with average costs per case averted of US$9, US$35 and US$47, respectively. Conclusions Prioritising nutrition investment to the most cost-effective interventions within the country context can maximise the impact of funding. A greater focus on complementing nutrition-specific interventions with nutrition-sensitive ones that address the social determinants of health is critical to reach the SDG targets.

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The impact of vitamin A supplementation on mortality inequalities among children in Nepal

Health Policy and Planning ◽

10.1093/heapol/czi007 ◽

2005 ◽

Vol 20 (1) ◽

pp. 60-66 ◽

Cited By ~ 17

Author(s):

David Bishai ◽

K C Samir Kumar ◽

Hugh Waters ◽

Michael Koenig ◽

Joanne Katz ◽

...

Keyword(s):

Vitamin A ◽

Vitamin A Supplementation ◽

The Impact

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Impact of Vitamin A Megadose Supplementation on the Anthropometry of Children and Adolescents with Non-Hormonal Statural Deficit: a Double-blind and Randomized Clinical Study

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.73.4.303 ◽

2003 ◽

Vol 73 (4) ◽

pp. 303-311 ◽

Cited By ~ 6

Author(s):

Sarni ◽

Kochi ◽

Ramalho ◽

Schoeps ◽

Sato ◽

...

Keyword(s):

Body Composition ◽

Food Intake ◽

Vitamin A ◽

Children And Adolescents ◽

Double Blind ◽

Vitamin A Supplementation ◽

Randomized Clinical Study ◽

Group I ◽

Group Ii ◽

The Impact

Objective: To evaluate the intake of retinol and carotenoids, and their serum levels, as well as the impact of vitamin A supplementation on the anthropometry and body composition of children and adolescents with non-hormonal-related statural deficit. Method: Double-blind, randomized trial of 46 pre-pubertal patients, between 4 and 14 years of age, with normal growth rates. The subjects were divided into two groups, each with 23 individuals (Group I: Placebo; Group II: Vitamin A in a single megadose), and were evaluated at moments A and B with a six month interval. Results: There were no statistically significant differences in serum retinol levels, anthropometry, growth velocity, or body composition, between moments A and B, in Group II. Carotenoids were significantly lower in Group I at moment B. The semi-quantitative food intake questionnaire showed that approximately 60.9% of the children and adolescents ingested less than half of the amounts of retinol and carotenoids recommended by the Food Guide Pyramid. Inadequate intake was more prevalent regarding vegetable and fruit carotenoid sources, with 75 and 70% of inadequacy, respectively. Conclusion: If one considers the inadequate food intake observed in the dietary evaluation in this study, it is possible that multiple micronutrient deficiencies could be involved in statural deficits. This could explain why vitamin A supplementation does not seem to influence growth in children and adolescents with statural deficit, as indicated by the present study. Thus in populations such as the one studied here, the supplementation with vitamin A should be integrated into comprehensive nutritional interventions, so as to possibly promote greater positive impact on linear growth.

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The impact of vitamin A supplementation on physical growth of children is dependent on season

European Journal of Clinical Nutrition ◽

10.1038/sj.ejcn.1600352 ◽

1997 ◽

Vol 51 (1) ◽

pp. 26-29 ◽

Cited By ~ 25

Author(s):

R Bahl ◽

N Bhandari ◽

S Taneja ◽

MK Bhan

Keyword(s):

Vitamin A ◽

Physical Growth ◽

Vitamin A Supplementation ◽

The Impact

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Vitamin a supplementation in terms of lifestyle disease

Progress in Health Sciences ◽

10.5604/01.3001.0013.3691 ◽

2019 ◽

Vol 1 ◽

pp. 90-97

Author(s):

M. Ślifirczyk ◽

B. Jędrzejewska ◽

A. Ślifirczyk ◽

A. Modestowicz-Dobrowolski ◽

K. Bochno

Keyword(s):

Higher Education ◽

Vitamin A ◽

Dietary Supplements ◽

Human Body ◽

The Body ◽

Survey Method ◽

State School ◽

Vitamin A Supplementation ◽

John Paul Ii ◽

The Impact

Introduction: Rational nutrition is one of the most important factors affecting human development, maintaining good health and prevention of civilization diseases. Purpose: To assess the state of knowledge among students from John Paul II State School of Higher Education in Biala Podlaska in the impact and effectiveness of vitamin A supplementation on the human body. As well as the assessment of students' knowledge concerning the problem of deficits and diseases caused the overdose of vitamin A. Materials and methods: The study was conducted among 70 students of the John Paul II State School of Higher Education in Biala Podlaska in the period March - April 2018. We used the diagnostic survey method based on the original questionnaire. Results: Students have knowledge about dietary supplements; they could indicate the main effect of the preparations. 62.86% of the respondents knew the correct definition of dietary supplements. They had difficulty with the term of vitamin A in the human body and the diseases caused by the lack of it. The problem was a detailed knowledge of the occurrence and impact on the body of vitamin A supplementation. A small percentage (14.29%) students have ever taken supplements. Conclusions: Students have knowledge about dietary supplements

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