scholarly journals Utilization of vitamin A supplementation services in high priority districts of Bihar

Author(s):  
Nivedita Sinha ◽  
Rajesh R. Sinha ◽  
Ajay Krishna ◽  
Rashmi Singh

Background: Vitamin A deficiency (VAD) is a major preventable public health problem. Prevalence of VAD in preschool children was 5.7% (India), and 4.5% (Bihar). India is implementing biannual Vitamin A Supplementation (VAS) since 2007 along with 80 other countries. VAS was originally proposed as a short term measure, followed by dietary improvement. Since vulnerability to VAD is more in high priority districts (HPDs), it was deemed worthwhile to study the extent to which VAS programme is utilized in the 10 HPDs of Bihar with respect to the processes involved and the ultimate outcome of empowering the community with knowledge and capacity to combat VAD on their own.Methods: Cross sectional observational study conducted in 6 randomly selected blocks and 5 session sites per block of the 10 HPDs. 300 sites sampled for processes and 893 caregivers interviewed for their knowledge.Results: Out of 300 sites, 269 sites found functional, 30.85% sites had due lists and 30.11% had MCP cards; 20.44% had adequate VA. IEC displayed at 52.78% and 71.3% sessions conducted in shade. In 79.55% sites efforts made to determine age of child before administration. Correct use of recommended spoon known to 80.66%, benefits of VA to 76.57% and diseases due to VAD to 81.7% of FLWs. Knowledge regarding VA good in 33.4% of caregivers, average in 35.5%, and poor in 30.9%.Conclusions: Crucial gaps found in necessary inputs and conduct of VAS. Community knowledge found lacking for sustainable programme withdrawal. Better programme management will improve utilization. 

Author(s):  
Augustin Nawidimbasba ZEBA ◽  
Jean Fidèle Bationo ◽  
Olivier Ouahamin Sombié ◽  
Jeoffray Diendéré

Background: Vitamin A deficiency (VAD) is still a public health problem across the globe and also in Burkina Faso, especially for under-five-years-old children. Since less information is available about the prevalence of VAD among the primary school children, this study aimed to study this area. Methods: A randomised double-blind placebo-controlled trial was conducted to assess the effect of high dose of vitamin A (VA) and daily zinc versus high dose of VA and daily zinc placebo (6 days per week) during four months among the primary school children. Of the total number of 200 school children, 100 were allocated to two random groups. Participants’ gender, age, weight, and height were measured, a blood smear was performed for malaria diagnosis, stool samples were collected for intestine parasites’ assessment, and blood samples were collected for haemoglobin and serum retinol measurement. Results: Baseline data of 183 school children were analysed and the findings showed that 20.6% of the school children were underweight (23.2% in girls vs. 16.5% in boys; P = 0.043). Anemia affected 36.2%, 39% had Plasmodium Falciparum, and 37.6% had intestine parasites. Furthermore, VAD prevalence was 46.1% (51.0% in boys vs. 41.2% in girls; P = 0,072). Conclusion: Among primary school children in the Western part of Burkina Faso, VAD is not only higher than other regions of the country, but also twice the critical level and defined as a severe public health problem by WHO. This result calls for action among the primary school children and recalls the importance of taking strategies against VAD among under-five-year-old children.


2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Zekariyas Sahile ◽  
Delelegn Yilma ◽  
Robel Tezera ◽  
Tadu Bezu ◽  
Werissaw Haileselassie ◽  
...  

Background. Vitamin A deficiency is a major nutritional concern in lower-income countries. The aim of this systematic review and meta-analysis was to show the magnitude of vitamin A deficiency among preschoolers in Ethiopia. Objective. The present study was aimed at synthesizing qualitatively and quantitatively the existing literature on the prevalence of VAD in preschool children in Ethiopia. Methods. Studies were searched through the search engine of Google Scholar, Hinari, MEDLINE/PubMed, Cochrane Library, and Africa-Wide Information. Searching was made using the keywords/MeSH of vitamin A deficiency, xerophthalmia, night blindness, Bitot’s spot, retinol, children, and Ethiopia. Data were analyzed and compared with the WHO threshold criteria to declare a public health problem. Heterogeneity among studies was assessed using a Cochran Q test and I2 statistics. A random-effects model with 95% confidence interval was used for prevalence estimations. Results. Of the 13 studies included in clinical analysis, 12 of them reported the prevalence of night blindness and/or Bitot’s spot among preschool children in Ethiopia which was above WHO cutoff point for the public health problem 1% and 0.5%, respectively. The prevalence of night blindness significantly decreased from moderate public health problem 4.2% (95% CI: 2.8%-5.7%) in a period from 1990 to 2004 to mild public health problem 0.8% (95% CI: 0.6%-1.0%) in a period from 2005 to 2019. Furthermore, statistically insignificant reduction was observed in the prevalence of Bitot’s spot in a period from 1990 to 2004, 2.2% (95% CI: 1.3%-3.2%) to 1.8% (95% CI: 1.2%-2.3%) in a period from 2005 to 2019. Among 8 studies on subclinical vitamin A deficiency, 7 of them indicated a severe public health problem (>20%). The prevalence of subclinical vitamin A deficiency decreased from 55.7% (95% CI: 39.8%-71.6%) in a period from 1990 to 2004 to 28.3% (95% CI: 9.8%-46.7%) in a period from 2005 to 2019, but not statistically significant. Conclusions. Despite the reduced proportion of night blindness and Bitot’s spot, still both clinical and subclinical vitamin A deficiencies remain a public health problem in Ethiopia requiring strengthen intervention through the newly initiated health extension program.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
A. M. Hamdy ◽  
M. M. Abdel Aleem ◽  
A. A. El-Shazly

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.


2006 ◽  
Vol 96 (2) ◽  
pp. 258-267 ◽  
Author(s):  
Mandy Porter Dosti ◽  
Jordan P. Mills ◽  
Philipp W. Simon ◽  
Sherry A. Tanumihardjo

Vitamin A (VA) deficiency is a worldwide public health problem. Biofortifying existing sources of β-carotene (βC) and increasing dietary βC could help combat the issue. Two studies were performed to investigate the relative βC bioavailability of a βC supplement to purple, high-βC orange, and typical orange carrots using Mongolian gerbils (Meriones unguiculatus). In study 1, which used a traditional bioavailability design, gerbils (n32) received a diet containing orange, purple, or white carrot powder, or white carrot powder +a βC supplement. In study 2, which included βC-biofortified carrots, gerbils (n 39) received orange, high-βC orange, purple, or white carrot powder in their diet. Both studies lasted 21 d and the gerbils were killed to determine the effect of carrot type or supplement on serum and liver βC, α-carotene, and VA concentrations. Liver stores of βC or VA in the gerbils did not differ between orange and purple carrot diets when equal amounts of βC from each of the diets were consumed (P>0·05). Both the orange and purple carrot diet resulted in higher liver VA compared with the supplement (P<0·05). High-βC carrots resulted in more than 2-fold higher βC and 1·1 times greater VA liver stores compared with typical orange carrots (P<0·05). These results suggest that high-βC carrots may be an alternative source of VA to typical carrots in areas of VA deficiency. Second, phenolics including anthocyanins and phenolic acids in purple carrot do not interfere with the bioavailability of βC from purple carrots.


Author(s):  
Susana Valido ◽  
Ermelinda do Carmo Caldeira ◽  
Felismina Mendes

Sociodemographic changes occurring in past decades are reflected as increased population aging, resulting in a higher need to institutionalize elderly. Violence against elderly is a relevant public health problem. The aims of the present cross-sectional exploratory and descriptive study with a quantitative approach were to analyze burnout among formal caregivers at institutions for elderly and to assess the risk of violence against institutionalized elderly. As a part of project ESACA—Envelhecer com Segurança no Alentejo (Prevenir as Quedas e a Violência sobre Idosos)—Compreender para Agir (Aging Safely in Alentejo [Preventing Falls and Violence against Elderly]), the present study analyzed 34 formal caregivers from three institutions that provide care to elderly in the Evora district, Portugal. No situations involving violence against institutionalized elderly were detected. Most participants (96.3%) did not exhibit burnout, although they did report feeling physically and emotionally tired.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getnet Kassa ◽  
Addisalem Mesfin ◽  
Samson Gebremedhin

Abstract Background In low- and middle-income countries routine vitamin A supplementation (VAS) is a key strategy for reducing vitamin A deficiency and mortality and morbidity of preschool children. However, in Ethiopia, there is paucity of evidence regarding the level and determinants of the uptake of the supplement. This study was designed to assess the coverage and predictors of VAS among preschool children in Humbo district, Southern Ethiopia. Methods A cross-sectional study was conducted in April 2016. A total of 840 mothers/caregivers having children 6–59 months of age were selected using multistage cluster sampling technique from six rural villages implementing routine VAS program. Data were collected using interviewer administered questionnaire. Possible predictors considered in the study include distance from the nearby health facility, household socio-economic status, type of the household (model vs non-model), maternal access to health education on VAS, and knowledge on vitamin A and VAS. Multivariable logistic regression analysis was performed to identify predictors of uptake of VAS. The outputs are presented using adjusted odds ratio (AOR) with the respective 95% confidence interval (CI). Results The coverage of VAS was 75.0% (95% CI: 72.1–77.9). Better knowledge of mothers about the importance of the supplement (AOR: 1.49, 1.02–2.17), obtaining VAS related information from frontline community health workers (AOR: 1.51, 1.34–2.72) than health professionals and being from households in the “rich” wealth tertile (AOR: 1.80, 95% CI: 1.07–3.03) were positively associated with uptake VAS. Conclusion The VAS coverage of the area was approaching the expected national target of 80%. However, the uptake can be enhanced though awareness creation and improving socio-economic status of the community.


2020 ◽  
Vol 5 (7) ◽  
pp. e001997
Author(s):  
Erin McLean ◽  
Rolf Klemm ◽  
Hamsa Subramaniam ◽  
Alison Greig

WHO recommends vitamin A supplementation (VAS) programmes for children 6–59 months where vitamin A deficiency is a public health problem. However, resources for VAS are falling short of current needs and programme coverage is suffering. The authors present the case for considering the options for shifting efforts and resources from a generalised approach, to prioritising resources to reach populations with continued high child mortality rates and high vitamin A deficiency prevalence to maximise child survival benefits . This includes evaluating where child mortality and/or vitamin A deficiency has dropped, as well as using under 5 mortality rates as a proxy for vitamin A deficiency, in the absence of recent data. The analysis supports that fewer countries may now need to prioritise VAS than in the year 2000, but that there are still a large number of countries that do. The authors also outline next steps for analysing options for improved targeting and cost-effectiveness of programmes. Focusing VAS resources to reach the most vulnerable is an efficient use of resources and will continue to promote young child survival.


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