scholarly journals Enablers of vitamin A coverage among children under five years of age from multi-country analyses of global demographic and health surveys in selected LMIC and LIC countries in Africa and Asia: a random forest analysis

2018 ◽  
Vol 6 (1) ◽  
pp. 395 ◽  
Author(s):  
Manoj Kumar Raut ◽  
J. C. Reddy ◽  
Debabrata Bera ◽  
Kirti Warvadekar
Keyword(s):  
Random Forest ◽  
Mass Media ◽  
Vitamin A ◽  
Health Surveys ◽  
Vitamin A Deficiency ◽  
Wealth Index ◽  
Demographic And Health Surveys ◽  
Vitamin A Supplementation ◽  
Mother’S Education ◽  
Mother's Education

Background: Vitamin A deficiency is a common form of micronutrient malnutrition. The estimated relative risks associated with vitamin A deficiency in children were 1.86 (95% CI 1.32–2.59) for measles mortality, 2.15 (95% CI 1.83–2.58) for diarrhoea mortality, 1.78 (95% CI 1.43–2.19) for malaria mortality, 1.13 (95% CI 1.01–1.32) for other infectious disease mortality. Vitamin A supplementation reduces night blindness, child morbidity and mortality.Methods: This paper tries to explore the socio-demographic causes of receipt of vitamin A in selected lower-middle-income and low income countries by analysing the data of the demographic and health surveys from 2012 and 2016 using PASW 18.0 software. Multivariate binary logistic regressions were conducted to explore the role of socio-demographic covariates in the receipt of vitamin A supplementation. In addition, random forest (RF) analyses were conducted using Python 3.6.Results: After adjusting for related socio-economic and demographic factors, mother’s work status and education and among mass media channels, exposure to television seems to play an important role in predicting receipt of vitamin A in the selected countries in Asia, while education of the mother was significantly associated with the receipt of vitamin A in the selected countries of Africa. In all the selected countries, the RF analyses revealed mother’s education followed by wealth index and mass media (TV), as the variable of most importance.Conclusions: It can be concluded that mother’s education and mass media seems to be working well in making the mothers aware about the vitamin A campaign, especially, the exposure to television. It also figures in the variable importance matrix in addition to wealth index.

scholarly journals Socio-demographic determinants of vitamin A supplementation in Bangladesh: evidence from two rounds of Bangladesh demographic and health surveys, 2007 and 2011

2018 ◽  
Vol 5 (3) ◽  
pp. 1149
Author(s):  
Manoj Kumar Raut
Keyword(s):  
Mass Media ◽  
Vitamin A ◽  
Confidence Interval ◽  
Health Surveys ◽  
Development Program ◽  
Prevalence Ratio ◽  
Current Status ◽  
Family Welfare ◽  
Demographic And Health Surveys ◽  
Vitamin A Supplementation

Background: Vitamin A supplementation reduces night blindness, child morbidity and mortality. In Bangladesh, Vitamin A deficiency among children 6-59 months has remained just about stagnant at 20.5 per cent as per the latest Bangladesh National Micronutrient Status Survey 2011-12 declining by a meagre 1.2 per cent from 21.7 per cent in 1997 (IPHN/HKI, 1997). Alarmingly, there is an absolute decline of 24 percentage points in VAS supplementation from 2007 to 2011 according to the Bangladesh Demographic & Health Surveys (BDHS). The current status of vitamin A supplementation raises concern because the Ministry of Health and Family Welfare (MoHFW)’s Health, Population and Nutrition Sector Development Program (HPNSDP) 2011-2016 target of 90 per cent needs to be achieved by 2016.Methods: This paper tries to explore the socio-demographic causes of receipt of Vitamin A in Bangladesh by analysing the data of the demographic and health surveys for 2007 and 2011 using SAS software. A log binomial regression was conducted to explore the effect of education and exposure to mass media on receipt of vitamin A supplementation.Results: After adjusting for related socio-economic and demographic factors, parent’s education and among mass media channels, television seems to play an important role in predicting receipt of Vitamin A, (Prevalence Ratio [PR]: 1.0973, 95% Confidence Interval [CI] 1.0499-1.1469) in BDHS 2011. Similarly, also those who watched television were more likely to have received vitamin A (Prevalence Ratio [PR]: 1.0542, 95% Confidence Interval [CI] 1.0304-1.0784).Conclusions: It can be concluded that mass media seems to be working well in making the mothers aware about the vitamin A campaign, especially, the exposure to television. Though mother’s education was not associated in the 2007 survey, but it was significantly associated with the receipt of vitamin A in the 2011 survey.

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 Early neonatal vitamin A supplementation and infant mortality: an individual participant data meta-analysis of randomised controlled trials

2018 ◽  
Vol 104 (3) ◽  
pp. 217-226 ◽  
Author(s):  
Keyword(s):  
Infant Mortality ◽  
Vitamin A ◽  
Maternal Education ◽  
Vitamin A Deficiency ◽  
Population Characteristics ◽  
Infant Survival ◽  
Vitamin A Supplementation ◽  
Maternal Vitamin ◽  
Early Infant ◽  
The Impact

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.

scholarly journals Effect of vitamin A on severity of acute diarrhea in children

2013 ◽  
Vol 53 (3) ◽  
pp. 125
Author(s):  
Marlisye Marpaung ◽  
Supriatmo Supriatmo ◽  
Atan Baas Sinuhaji
Keyword(s):  
Vitamin A ◽  
Acute Diarrhea ◽  
Vitamin A Deficiency ◽  
Stool Consistency ◽  
Chi Square ◽  
Vitamin A Supplementation ◽  
Body Weights ◽  
Group 2 ◽  
Stool Volume ◽  
Group 1

Background Vitamin A deficiency may increase the risk or bea cause of diarrhea. Many studies have been conducted on theefficacy of vitamin A in the management of acute diarrhea, butthe outcomes remain inconclusive.Objective To determine the effectiveness of vitamin A in reducingthe severity of acute diarrhea in children.Methods We performed a single􀁈blind􀁈randomized controlledtrial in the Secanggang District, Langkat Regency, North ofSumatera, from August 2009 to January 2010 in children aged6 months to 5 years, who had diarrheas. Subjects were dividedinto two groups. Group 1 received a single dose of vitamin A(100,000 IU for subjects aged 6 to 11 month old or with bodyweights :s 10 kg, or 200,000 IU for subjects aged 2: 12 month oldor with body weights> 10 kg). Group 2 received a single doseof placebo. The establishment of severity was based on changesin diarrheal frequency, stool consistency, volume and durationof diarrhea after treatment. We performed independent T􀁈testand Chi square tests for statistical analyses. The study was anintention􀁈to􀁈treat analysis.Results We enrolled 120 children who were randomized intotwo groups of 60 subjects each. Group 1, received vitamin Aand group 2 received a placebo. The results showed significantdifferences between the two groups in stool volume starting onthe first day (95%CI 192.30 to 3237.51; P􀁉O.OOI), as well asdiarrheal frequency (P=O.OOl) and stool consistency (P=O.OOl)on the second day observation and duration of diarrhea followingtreatment (95%CI - 40.60 to - 25.79; P􀁉O.OOI;).Conclusions Vitamin A supplementation is effective in reducingthe severity of acute diarrhea in children under five years of age.[Paediatr lndones. 2013;53:125-31.]

scholarly journals Socioeconomic and Demographic Determinants of Body Mass Index in Sudan: A Predictive Model

2021 ◽  
Vol 14 (1) ◽  
pp. 478-483
Author(s):  
Ahmed Abdallah ◽  
Mohammed Mohammed ◽  
Dawit Ayele
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Multinomial Logistic Regression ◽  
Wealth Index ◽  
Normal Weight ◽  
Children Under Five ◽  
Under Five ◽  
Body Mass Index Status ◽  
Mother’S Education ◽  
Mother's Education

Background: This paper aimed to determine the socioeconomic and demographic determinants related to Body Mass Index (BMI) for children under five years in Sudan. The objective of the study was to identify the factors of BMI for under-five children. Methods: This study used the Sudan Multiple Indicator Cluster Survey (MICS) conducted in the year 2014. The multinomial logistic regression model was adopted. Results: Results revealed that the prevalence of underweight infants under five years was 86.3% in females and 85.3% in males, while the proportion of the normal weight of infants under five years of age for males was slightly higher than females; there was a correlation amid geographic determinants, state, and BMI status. Also, there was a significant association between the mother’s education and body mass index status and the wealth index and body mass index status. The variables place of residence and sex did not show a statistically significant relationship with body mass index status for children under five years of age in Sudan. Conclusion: The risk factors significantly associated with body mass were the state, whether the child had ever been breastfed, sex, mother’s education, wealth index, and age in the month.

scholarly journals Odds of Receiving Vaccines, but Not Vitamin A, Increased over Time in Urban and Rural Ethiopia, 2000–2016: A Secondary Data Analysis of DHS Data (P04-095-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lauren Blacker ◽  
Shari Krishnaratne
Keyword(s):  
Child Health ◽  
Vitamin A ◽  
Health Systems ◽  
Rural Areas ◽  
Development Program ◽  
Wealth Index ◽  
Education Level ◽  
Demographic And Health Surveys ◽  
Access To Health ◽  
Over Time

Abstract Objectives Childhood vaccines and biannual vitamin A delivery by health systems are key to child health; suboptimal administration may be a result of inadequate coverage or access to health systems. There have been national programs set in Ethiopia, such as the health sector development program, to improve child health. Therefore, we sought to describe trends in infant vaccines and vitamin A in urban and rural settings in Ethiopia. We hypothesized there would be an increase over time in infants (1) receiving all basic vaccines and (2) vitamin A in the past 6 months. We also hypothesized (3) coverage would be higher in urban settings. Methods We used four nationally representative Demographic and Health Surveys (DHS) from Ethiopia between 2000 and 2016. The analysis comprised 11,621 infants 6–23 months old. Logistic regression models using a forward-stepwise approach were created to test these 3 hypotheses, controlling for wealth, age, sex of infant, and mother's highest education level. Interaction terms were fitted between survey year and education level, setting and education level, and setting and wealth index quintile, and tested using the Wald test. Results (1) The percentage of infants having received all basic vaccines increased from 11.1% in 2000 to 31.0% in 2016; the odds of having received these vaccines increased over time also. (2) This is not true for vitamin A, where there was no pattern in the odds of having received vitamin A between survey years. (3) Rural infants were 40% less likely to have received all basic vaccines, compared to urban infants (adjusted odds ratio (AOR): 0.60; 95% CI: 0.43, 0.83), and there was no evidence of an association between setting and receiving vitamin A (AOR: 0.81; 95% CI: 0.61, 1.09). There was strong evidence for interaction between setting and mother's highest education level, setting and wealth index quintile, and survey year and education level (all P < 0.01). Conclusions These results suggest that (1) while there has been improvement in infants receiving basic vaccines, (2) progress may be slowing slightly in vitamin A coverage and (3)there is a need to improve coverage of basic vaccines for infants in rural areas. Strengthening of and improved access to health services should remain a priority to ensure proper distribution of vaccines and vitamin A in Ethiopia. Funding Sources N/A. Supporting Tables, Images and/or Graphs

scholarly journals Uptake of routine vitamin A supplementation for children in Humbo district, southern Ethiopia: community-based cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getnet Kassa ◽  
Addisalem Mesfin ◽  
Samson Gebremedhin
Keyword(s):  
Preschool Children ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Southern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vitamin A Supplementation ◽  
Socio Economic Status

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.

scholarly journals Refocusing vitamin A supplementation programmes to reach the most vulnerable

2020 ◽  
Vol 5 (7) ◽  
pp. e001997
Author(s):  
Erin McLean ◽  
Rolf Klemm ◽  
Hamsa Subramaniam ◽  
Alison Greig
Keyword(s):  
Vitamin A ◽  
Child Mortality ◽  
Vitamin A Deficiency ◽  
Child Survival ◽  
Public Health Problem ◽  
Mortality Rates ◽  
Vitamin A Supplementation ◽  
Use Of Resources ◽  
Year 2000 ◽  
Programme Coverage

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.

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.

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