scholarly journals Vitamin A capsule distribution to control vitamin A deficiency in Indonesia: effect of supplementation in pre-school children and compliance with the programme

2003 ◽  
Vol 6 (2) ◽  
pp. 209-216 ◽  
Author(s):  
Rosnani Pangaribuan ◽  
Jürgen G Erhardt ◽  
Veronika Scherbaum ◽  
Hans K Biesalski
Keyword(s):  
Vitamin A ◽  
Rural Areas ◽  
Vitamin A Deficiency ◽  
Marginal Effect ◽  
Serum Retinol ◽  
Vitamin A Supplementation ◽  
Reactive Protein ◽  
Central Java ◽  
Urban And Rural Areas ◽  
Sick Children

AbstractObjective:The aim of this study was to evaluate the effectiveness of a widespread vitamin A supplementation programme and to describe indicators of compliance with the programme in Indonesia.Design:Prospective cohort study. Children's anthropometric data were gathered at baseline (June 2000) and 4 months later (2 months after supplementation in August 2000). Serum retinol, haemoglobin, ferritin, α1-acid glycoprotein and C-reactive protein were measured at baseline and at follow-up. Caregivers of the children were interviewed using a questionnaire.Setting:Semi-urban and rural areas of Semarang district, Central Java, Indonesia.Subjects:Children (n = 400) aged 1–5 years.Results:After the supplementation, the proportion of children with a low concentration of retinol decreased in recipients from 18.8 to 14.5%. However, in non-recipients, the prevalence of vitamin A deficiency increased from 31.9 to 37.5%, this prevalence being significantly higher than in recipients. A significant decrease occurred in the proportion of recipients with low ferritin (26.5 to 16.2%) and haemoglobin (25.7 to 15.3%), whereas the proportions did not show a significant change after supplementation for non-recipients. Modest linear growth was detected in recipients after supplementation but there was no effect on ponderal growth. The coverage rate of the supplementation in the study areas was 60%. There was an association between compliance of the caregivers and their knowledge about the potential benefit of vitamin A supplementation, the place where sick children were taken and age of the children.Conclusions:The vitamin A supplementation programme marginally decreased the proportion of vitamin A deficiency and had a marginal effect on the nutritional status of recipients. More than one micronutrient intervention is needed to increase the effectiveness of the supplementation programme. To increase compliance and coverage in the supplementation programme, nutrition communication and private healthcare practices need to be included in the programme.

scholarly journals Rural-urban determinants of vitamin a deficiency among under 5 children in Bangladesh: Evidence from National Survey 2017–18

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Md. Moyazzem Hossain ◽  
Sabina Yeasmin ◽  
Faruq Abdulla ◽  
Azizur Rahman
Keyword(s):  
Vitamin A ◽  
Rural Areas ◽  
Urban Areas ◽  
Vitamin A Deficiency ◽  
Vulnerable Groups ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Data Set ◽  
Vitamin A Supplementation ◽  
Urban And Rural Areas

Abstract Background Vitamin A supplementation reduces child morbidity, mortality, and blindness of people, especially in developing countries like Bangladesh. This study explores significant determinants of vitamin A deficiency among preschool children in rural and urban areas of Bangladesh. Methods The data set was extracted from a nationally representative survey based on a cross-sectional study, the BDHS-2017-18. The base survey was conducted using a two-stage stratified sample of households. A sample of 8364 (urban 2911, rural 5453) children under-5 years old was analyzed using bivariate and multivariate statistical techniques. Results Results have demonstrated that 73.9 and 73.2% of children have had a vitamin A supplementation from urban and rural areas, respectively. Logistic regression analysis showed that parents’ education plays a vital role in consuming vitamin A supplements in urban and rural areas. Children whose mothers have secondary (OR: 1.17, CI: 0.76–1.81) and higher (OR: 1.21, CI: 0.72–2.04) education were more likely to consume vitamin A supplementation than children whose mothers were illiterate in urban areas. However, in rural areas, children whose mothers have secondary education were about 24% and higher education with 60% more likely to consume vitamin A supplementation than children whose mothers were illiterate. Child’s age, regional variation and wealth index also contributing factors for vitamin A deficiency in Bangladesh. Conclusions These findings indicated that the consumption of vitamin A does not cover the target of sustainable development goals. Thus special national and community level efforts are required to ensure the coverage of the national vitamin A program is increased adequately to the most vulnerable groups of children in Bangladesh.

Vitamin A Supplementation and Measles

1995 ◽  
Vol 16 (9) ◽  
pp. 358-359
Author(s):  
Glenn J. Fennelly
Keyword(s):  
Vitamin A ◽  
Acute Phase ◽  
Vitamin A Deficiency ◽  
Serum Levels ◽  
Morbidity And Mortality ◽  
Serum Retinol ◽  
Vitamin A Supplementation

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).

scholarly journals SEANUTS: the nutritional status and dietary intakes of 0.5–12-year-old Thai children

2013 ◽  
Vol 110 (S3) ◽  
pp. S36-S44 ◽  
Author(s):  
Nipa Rojroongwasinkul ◽  
Kallaya Kijboonchoo ◽  
Wanphen Wimonpeerapattana ◽  
Sasiumphai Purttiponthanee ◽  
Uruwan Yamborisut ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
Nutritional Status ◽  
Rural Areas ◽  
Urban Areas ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Rural Children ◽  
Major Public Health Problem ◽  
Serum Retinol

In the present study, we investigated nutritional status and health-related factors in a multistage cluster sample of 3119 Thai urban and rural children aged 0·5–12·9 years. In a subsample, blood samples were collected for the measurement of Hb, transferrin receptor, vitamin A and vitamin D concentrations. The prevalence of stunting and underweight was higher in rural children than in urban children, whereas the wasting rate was similar in both rural and urban areas. Among children aged 3·0–5·9 years, the prevalence of overweight was significantly higher in urban areas than in rural areas and so was the obesity rate in children aged 6·0–12·9 years. Protein intakes of all age groups were relatively high in both the areas. Intakes of Ca, Fe, Zn and vitamin C were significantly higher in urban areas than in rural areas. The prevalence of anaemia in rural areas was twice as high as that in urban areas, particularly in infants and young children. However, the prevalence of Fe-deficiency anaemia was similar in both urban and rural areas. While the prevalence of vitamin A deficiency (by serum retinol cut-off < 0·7 μmol/l) seemed to be very low, vitamin A insufficiency (by serum retinol cut-off < 1·05 μmol/l) was more prevalent (29·4–31·7 %) in both the areas. The prevalence of vitamin D insufficiency ranged between 27·7 and 45·6 % among the children. The present study indicates that the double burden of malnutrition is still a major public health problem in Thailand. Further studies need to explore the associated risk factors for these nutrient deficiencies. Effective strategies and actions are needed to tackle the nutritional problems in Thai children.

Vitamin A deficiency - experience from a tertiary referral UK hospital; not just a low- and middle-income country issue

2021 ◽  
pp. 1-15
Author(s):  
Alexandra Marley ◽  
Samuel CL Smith ◽  
Ruhina Ahmed ◽  
Peter Nightingale ◽  
Sheldon C Cooper
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Binary Logistic Regression ◽  
Signs And Symptoms ◽  
University Teaching ◽  
Serum Retinol ◽  
Middle Income ◽  
Reactive Protein ◽  
Active Inflammation ◽  
Low And Middle Income

Abstract Objective: Vitamin A (VA) deficiency, more common in low- and middle-income countries (LMIC) secondary to malnutrition, is associated with increased morbidity and mortality. The prevalence and impact of VA deficiency in high-income countries (HIC) where chronic conditions may predispose is less well understood. Setting: We examined the scale of low and deficient VA status in our tertiary University Teaching Hospital (HIC). Participants: Patients undergoing serum retinol concentrations 2012-2016 were identified from laboratory records, and records examined. Design: Interpretation of serum retinol may be affected by inflammation, so C-reactive protein (CRP) levels were sought. Binary logistic regression and generalised estimating equations were performed to review the relationship between CRP and VA. Results: 628 assays were requested, with 82 patients VA low (0.7-0.99umol/L) or deficient (<0.7umol/L). 16 patients were symptomatic (15 deficient), predominantly visual. Only one symptomatic patient’s VA deficiency was secondary to poor intake. Other symptomatic patients had chronic illnesses resulting in malabsorption. The incidence of a low VA level increases significantly with a raised CRP. Conclusion: The majority of patients tested either were replete or likely to have abnormal VA levels due to concomitant inflammation. A minority of patients had signs and symptoms of VA deficiency and was a cause of significant morbidity, but aetiology differs from LMIC, overwhelmingly malabsorption, most commonly secondary to surgery or hepatobiliary disease. A correlation between inflammation and low VA levels exists, which raises the possibility that requesting a VA level in an asymptomatic patient with active inflammation may be of questionable benefit.

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

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 &gt;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 &gt;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.

scholarly journals Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India

2011 ◽  
Vol 15 (4) ◽  
pp. 568-577 ◽  
Author(s):  
Avula Laxmaiah ◽  
Madhavan K Nair ◽  
Nimmathota Arlappa ◽  
Pullakhandam Raghu ◽  
Nagalla Balakrishna ◽  
...  
Keyword(s):  
Vitamin A ◽  
School Children ◽  
Rural Areas ◽  
Vitamin A Deficiency ◽  
Economic Status ◽  
Dried Blood Spots ◽  
Sampling Procedure ◽  
Serum Retinol ◽  
Cross Sectional ◽  
Ocular Signs

AbstractObjectiveTo assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children.DesignA community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure.SettingRural areas of eight states in India.SubjectsPre-school children and their mothers were covered.ResultsA total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0·8 %. The total ocular signs were significantly higher (P < 0·001) among boys (2·6 %) compared with girls (1·9 %) and in older children (3–4 years) compared (P < 0·001) with younger (1–2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR = 3·8; 95 % CI 2·9, 5·0), labourers (OR = 2·9; 95 % CI 2·1, 3·9), illiterate mothers (OR = 2·7; 95 % CI 2·2, 2·3) and households without a sanitary latrine (OR = 5·9; 95 % CI 4·0, 8·7). Subclinical VAD (serum retinol level <20 μg/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %.ConclusionsThe study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.

scholarly journals The Effects of Two Maternal Vitamin A Supplementation Regimens on Serum Retinol in Postpartum Mothers: A Randomised Controlled Trial in Brazil

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Luciana Marques Andreto ◽  
Ilma Kruze Grande de Arruda ◽  
Ariani Impieri Souza ◽  
José Natal Figueiroa ◽  
Alcides da Silva Diniz
Keyword(s):  
Randomised Controlled Trial ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Controlled Trial ◽  
Serum Retinol ◽  
Double Blind ◽  
Vitamin A Supplementation ◽  
Treatment Groups ◽  
Randomised Controlled ◽  
Postpartum Mothers

Objective. To test whether the serum retinol level in mothers supplemented with 400,000 IU of vitamin A is higher than in those supplemented with 200,000 IU and to estimate duration of the protective effect of vitamin A supplementation in the serum retinol level. Methods. Double-blind, randomised controlled trial performed in two hospitals in the state of Pernambuco in northeast Brazil. Three hundred twelve mothers were recruited immediately postpartum. All women received a capsule containing 200,000 IU of vitamin A, and 10 days after delivery, they were randomly assigned to one of two treatment groups. One group received a second capsule containing vitamin A and the other group received a placebo. Each group was invited back after 2, 4, and 6 months for serum retinol analyses. Results. No difference was found between the two groups in serum maternal retinol concentration at 2 months (2.13 versus 2.03 μmol/L), 4 months (2.20 versus 2.24 μmol/L) or 6 months (2.29 versus 2.31 μmol/L). Because there was no further effect and because this population has a level of vitamin A deficiency considered mild, our results do not support a proposal to increase the dosing schedule for vitamin A in postpartum women as recommended by the IVACG.

scholarly journals Maternal Vitamin A Deficiency during Pregnancy and Its Relation with Maternal and Neonatal Hemoglobin Concentrations among Poor Egyptian Families

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
A. M. Hamdy ◽  
M. M. Abdel Aleem ◽  
A. A. El-Shazly
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Maternal Serum ◽  
Major Public Health Problem ◽  
Serum Retinol ◽  
Cross Sectional ◽  
Vitamin A Supplementation ◽  
Term Newborns

Background. Vitamin A deficiency (VAD) during pregnancy represents a major public health problem in developing countries. Anemia is a common consequence of VAD. We aimed to measure serum retinol concentrations of a sample of poor Egyptian mothers and correlate it with their Hb% and cord Hb%. Methods. This cross-sectional study included 200 healthy mothers and their healthy full term newborns. Maternal and cord blood samples were collected for CBC and measurement of serum retinol concentrations. Results. Forty-seven mothers (23.5%) had VAD and 50% were anemic. Mothers with VAD had a significantly lower mean Hb% and a significantly higher frequency of anemia (95.7%) compared to mothers without VAD (35.9%). The relative risk for anemia among mothers with VAD was 2.7 (CI = 2.12–3.3). Newborns of mothers with VAD had a significantly lower mean cord Hb% compared to newborns of mothers without VAD. Maternal serum retinol concentrations were positively correlated with maternal Hb% and cord Hb%. Conclusion. Maternal VAD during pregnancy among poor mothers is associated with maternal anemia and lower Hb% of newborns at birth. Vitamin A supplementation is highly recommended for this vulnerable group.

scholarly journals The relationship between serum retinol concentrations and subclinical infection in rural Brazilian children

2018 ◽  
Vol 31 (3) ◽  
pp. 299-310
Author(s):  
Laísla França da Silva TELES ◽  
Adriana de Azevedo PAIVA ◽  
Liania Alves LUZIA ◽  
Flávia Emília Leite de LIMA-FERREIRA ◽  
Cecilia Maria Resende Gonçalves de CARVALHO ◽  
...  
Keyword(s):  
Vitamin A ◽  
High Performance ◽  
Vitamin A Deficiency ◽  
Subclinical Infection ◽  
Rural Settlements ◽  
Serum Retinol ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
The Relationship

ABSTRACT Objective To evaluate the relationship between serum retinol concentrations and subclinical infection in children from rural settlements. Methods A cross-sectional population-based study was carried out in nine rural settlements in the northeastern region of Brazil, involving 118 children aged 6 to 59 months. The relationship between serum retinol and C-Reactive Protein levels, an important marker of infectious and inflammatory processes, was investigated by multiple linear regression, controlling for demographic, socioeconomic and nutritional variables. Serum retinol and C-Reactive Protein were measured, respectively, by High Performance Liquid Chromatography and immunoturbidimetric assay in automated equipment. Results Vitamin A deficiency (retinol <0.70μmol/L) was identified in 9.3% of the children. C-Reactive Protein was the only predictor of retinol concentrations in the final regression model, causing a 0.728μmol/L reduction in retinol concentrations in the studied children (p=0.008). Conclusion Vitamin A deficiency is a problem of mild/moderate severity and measures to control infectious diseases in this population are fundamental to prevent and/or combat this problem.

Research Recommendations for Applying Vitamin A-Labelled Isotope Dilution Techniques to Improve Human Vitamin A Nutrition

2014 ◽  
Vol 84 (Supplement 1) ◽  
pp. 52-59 ◽  
Author(s):  
Sherry A. Tanumihardjo ◽  
Anura V. Kurpad ◽  
Janet R. Hunt
Keyword(s):  
Public Health ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Human Subjects ◽  
The Body ◽  
Pool Size ◽  
Serum Retinol ◽  
Vitamin A Status ◽  
Status Assessment ◽  
Total Body

The current use of serum retinol concentrations as a measurement of subclinical vitamin A deficiency is unsatisfactory for many reasons. The best technique available for vitamin A status assessment in humans is the measurement of total body pool size. Pool size is measured by the administration of retinol labelled with stable isotopes of carbon or hydrogen that are safe for human subjects, with subsequent measurement of the dilution of the labelled retinol within the body pool. However, the isotope techniques are time-consuming, technically challenging, and relatively expensive. There is also a need to assess different types of tracers and doses, and to establish clear guidelines for the use and interpretation of this method in different populations. Field-friendly improvements are desirable to encourage the application of this technique in developing countries where the need is greatest for monitoring the risk of vitamin A deficiency, the effectiveness of public health interventions, and the potential of hypervitaminosis due to combined supplement and fortification programs. These techniques should be applied to validate other less technical methods of assessing vitamin A deficiency. Another area of public health relevance for this technique is to understand the bioconversion of β-carotene to vitamin A, and its relation to existing vitamin A status, for future dietary diversification programs.

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