Analysis for policy to overcome barriers to reducing the prevalence of vitamin a deficiency among children (15–23 months) in Iran

Abstract Background About 30% of children < 5 years old are estimated to experience vitamin A deficiency worldwide. Globally, vitamin A deficiency can be reduced by five major interventions: supplementation, dietary modification, fortification, promotion of both public health, and breastfeeding. This prospective policy analysis (Prospective policy analysis focuses on the future outcomes of a proposed policy. Adapted from Patton, CV, and Sawicki DS. Basic Methods of Policy Analysis and Planning, Prentice-Hall, Inc. New Jersey,1993). (Patton A, Carl V, and David S. Basic methods of policy analysis and planning, prentice-hall, 3th ed. 2012) aimed to identify evidence-based policy options to minimize prevalence (VAD) among 15–23 months-children in Iran. Methods Thirty-eight semi-structured face-to-face interviews were held with experts at high, middle, and low managerial levels in Iran’s health system, as well as at Schools of Nutrition Sciences and dietetics, using purposive and snowball sampling. All interviews were recorded by a digital voice recorder and then transcribed, codified, and eventually analyzed using a mixed approach (inductive-deductive) by MAXQDA software version 10. Results Most policies related to VAD reduction in this age group are supplementation, expansion of education, and awareness. Three main factors affecting VAD reduction policies emerged from the analysis: basic factors (governance, infrastructure, and organization), underlying factors (social factors, economy), and immediate factors (services). Due to its cross-sectoral nature, evaluating the results of the implementation of this policy requires strong and coherent inter-sectoral cooperation. The existing primary healthcare network (PHC) is a crucial means for successful implementation of policies to address VAD in Iran. Conclusions In addition to supplementation and assistance in this age group, other policies should be also planned to reduce VAD in various regions. In addition to the Ministry of Health & Medical Education (MoHME), other actors need to be involved, we advocate, throughout the entire policymaking process of policy-making to reduce VAD in Iran.

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FACTORS AFFECTING THE PETT VISUAL TEST FOR VITAMIN A DEFICIENCY

Canadian Journal of Research ◽

10.1139/cjr41b-014 ◽

1941 ◽

Vol 19b (4) ◽

pp. 99-108

Author(s):

L. B. Pett ◽

Marian K. Lipkind

Keyword(s):

Vitamin A ◽

Diurnal Rhythm ◽

Standard Error ◽

Learning Effect ◽

Vitamin A Deficiency ◽

Bright Light ◽

Visual Test ◽

Factors Affecting ◽

Test Room ◽

The Mean

Under the conditions prescribed for the Pett test, which is described, it has been found that: (i) antecedent light does not affect the median of the three tests usually performed; (ii) no error results from the wearing or not wearing of glasses; (ii) the use of pilocarpine to contract the pupils is not advisable; (iv) some light may be admitted into the test room; (v) the time of exposure to the bright light (30 sec.) is suitable; (vi) repeated tests cause a 'learning' effect so rarely as to be of little concern; (vii) the standard error of the mean is ±1.4 and of the median is ±2.4 sec. Some results are presented suggesting that a diurnal rhythm in the vitamin A content of the blood exists.

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Quantification of Vitamin A in Fortified Rapeseed, Groundnut and Soya Oils Using a Simple Portable Device: Comparison to High Performance Liquid Chromatography

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000154 ◽

2013 ◽

Vol 83 (2) ◽

pp. 122-128 ◽

Cited By ~ 4

Author(s):

Cécile Renaud ◽

Jacques Berger ◽

Arnaud Laillou ◽

Sylvie Avallone

Keyword(s):

High Performance Liquid Chromatography ◽

Liquid Chromatography ◽

Vitamin A ◽

High Performance ◽

Vitamin A Deficiency ◽

Developed Countries ◽

Portable Device ◽

Least Developed Countries ◽

Control Food ◽

Assay Precision

Vitamin A deficiency is still one of the major public health problems in least developed countries. Fortification of vegetable oils is a strategy implemented worldwide to prevent this deficiency. For a fortification program to be effective, regular monitoring is necessary to control food quality in the producing units. The reference methods for vitamin A quantification are expensive and time-consuming. A rapid method should be useful for regular assessment of vitamin A in the oil industry. A portable device was compared to high-performance liquid chromatography (HPLC) for three plant oils (rapeseed, groundnut, and soya). The device presented a good linearity from 3 to 30 mg retinol equivalents per kg (mg RE.kg- 1). Its limits of detection and quantification were 3 mg RE.kg- 1 for groundnut and rapeseed oils and 4 mg RE.kg- 1 for soya oil. The intra-assay precision ranged from 1.48 % to 3.98 %, considered satisfactory. Accuracy estimated by the root mean squares error ranged from 3.99 to 5.49 and revealed a lower precision than HPLC (0.4 to 2.25). Although it offers less precision than HPLC, the device estimates quickly the vitamin A content of the tested oils from 3 or 4 to 15 mg RE.kg- 1.

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

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000185 ◽

2014 ◽

Vol 84 (Supplement 1) ◽

pp. 52-59 ◽

Cited By ~ 5

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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Vitamin A deficiency is associated with disease severity in patients with liver cirrhosis

10.1055/s-0039-3402154 ◽

2020 ◽

Author(s):

M Nagel ◽

C Labenz ◽

M Nguyen-Tat ◽

N Cabezas Wallscheid ◽

C Czauderna ◽

...

Keyword(s):

Liver Cirrhosis ◽

Vitamin A ◽

Disease Severity ◽

Vitamin A Deficiency

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Mitral Valve Replacement in an Adult with Left Pulmonary Agenesis

The Heart Surgery Forum ◽

10.1532/hsf.1311 ◽

2015 ◽

Vol 18 (3) ◽

pp. 109

Author(s):

Huseyin Saskin ◽

Mustafa Idiz ◽

Cagri Duzyol ◽

Huseyin Macika ◽

Rezan Aksoy

Keyword(s):

Mitral Valve ◽

Vitamin A ◽

Valve Replacement ◽

Viral Infections ◽

Vitamin A Deficiency ◽

Pulmonary Agenesis ◽

Pulmonary Vessels ◽

Live Births ◽

Factors Associated ◽

Female Predominance

Pulmonary agenesis is associated with the absence of pulmonary vessels, bronchi, or parenchyma. This condition usually occurs between the 4th and 5th week of gestation during the embryonic phase. Etiopathogenic factors associated with pulmonary agenesis are not fully understood. In the literature, genetic and teratogenic factors, viral infections, and vitamin-A deficiency are shown to be associated with pulmonary agenesis [Malcon 2012]. This condition may be seen unilaterally or bilaterally. Although the precise rate of incidence is unknown, it is estimated to occur in one of every 10,000 to 12,000 live births [Yetim 2011]. There is a 1.3:1 female predominance with unilateral agenesis [Halilbasic 2013]

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Retinol, α-Tocopherol and Vitamin D3 in White MuscleDisease

Medycyna Weterynaryjna ◽

10.21521/mw.6029 ◽

2018 ◽

Vol 74 (1) ◽

pp. 6029-2018

Author(s):

HANDAN MERT ◽

SERKAN YİLDİRİM ◽

IBRAHİM HAKKİ YORUK ◽

KİVANC IRAK ◽

BAHAT COMBA ◽

...

Keyword(s):

Vitamin A ◽

Vitamin D3 ◽

White Muscle ◽

Bone Structure ◽

Early Stage ◽

Vitamin A Deficiency ◽

Muscle Disease ◽

Control Group ◽

White Muscle Disease ◽

Fat Soluble Vitamins

Vitamins are essential for the health of all living organisms. Vitamins E, A, D and K are known as fat-soluble vitamins, and deprivation of vitamin E causes various disorders, especially in the reproduction and cardiovascular systems and in muscle functions. Vitamin A, on the other hand, has roles in various biological functions – like eyesight – and the growth, reproduction and differentiation of epithelial cells. Vitamin A deficiency leads to the keratinization of the epithelium, and disorders related to the metaplasies of the genital and genitourinary systems. Conversely, vitamin D is defined as a pro-hormone and is responsible for Cahomeostasis, and thus indirectly affects the bone metabolism, bone structure, and cellular and neural functions of Ca. White muscle disease (WMD) can occur in newborn lambs, but is more commonly seen in lambs of up to 3 months of age. In this study, 30 lambs of 3 to 50-days-old from different flocks diagnosed with White Muscle Disease (WMD) were selected as research material, while the control group consisted of 8 healthy lambs. With the aim of clarifying the cause of WMD, serum fat-soluble vitamins, retinol, α-tocopherol and vitamin D3 levels were determined in 16 lambs. Gluteal and heart musclet issue samples also were taken from 30 lambs with WMD. The vitamin levels of the samples were analysed by HPLC. The levels of serum α-tocopherol, retinols, and vitamin D3 were foundto be low in the diseased animals, but only retinol (p<0.001) and α-tocopherol (p<0.0011) level differences were statistically relevant. Macroscopically, Zenker’s necrosis was determined in the heart muscles of 17 lambs, and in the gluteal and chest muscles of 6 lambs. 7 lambs displayed necrosis in both their heart and in gluteal muscles. The samples were analyzed microscopically to reach similar findings: swollen homogeneous pink muscles, pycnotic nuclei, and hyperaemic and haemorrhagic blood vessels in gluteal, chest and heart muscles. Hyaline degeneration and Zenker's necrosis, dystrophic regions in necrotic areas, cc was detected as a severe disease in lambs at an early stage of life with advanced degeneration in different muscle tissues. Deficiency of fat-soluble vitamins was also detected in the sick animals. Control group lambs had higher levels of α tocopherol and retinol (p<0.001) compared to the sick lambs. .

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