scholarly journals The determinant of National Vitamin A supplementation in Ethiopia: A Multilevel Logistic Regression Analysis

2020 ◽  
Author(s):  
Mohammed M. Oumer ◽  
Zelalem Mengestu ◽  
Sewbesew Yitayih ◽  
Malede Mequanent ◽  
Ayenew Molla
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Vitamin A ◽  
Low Income ◽  
Associated Factors ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Linear Mixed Effect Model ◽  
Mixed Effect ◽  
Vitamin A Supplementation

Abstract Background: Vitamin A deficiency is a public health problem in many low-income countries including Ethiopia. Globally, the prevalence of vitamin A deficiency is estimated to be 190 million among children under-five age causing one up to two million deaths annually.Its periodic supply is a major intervention program to reduce the morbidity, mortality, and blindness among the children in Ethiopia. Objective: The aim of this study was to determine associated factors of national vitamin A supplementationamong children aged 6-59 monthsusing the 2016 Ethiopian Demographic and Health Survey Data. Methods: A population based cross-sectional study design wasperformed to determine factors associated with the vitamin A supplyamong children aged between 6 and 59 monthswithin the last six months before the start of the survey. A univariateanalysis, bivariate analysis, binary logistic regression, and generalized linear mixed effect model were appliedto analyze the data. Results: After adjusting for covariates; the odds of taking vitamin A supply were 1.3 times, 1.7 times, and 1.8 times higher among the women who had two, three, and four and above antenatal care visits, respectively. The mothers’ employment status, health cheek up after their delivery,and theirhealth facility delivery were positively influence the uptake of the vitamin A capsule. In addition,women residing in the communities with high proportion of the media exposure[AOR (Adjusted Odds Ratio) = 1.17 (95%CI: 1.00, 1.37)]were positively associated with the receipt of vitamin A capsule.Random effects indicated that the variation on the uptake of vitamin A supplementation between the communities was statistically significant in all stage of the models. Conclusions: The individual and community level characteristics had a significant influence on the uptake of vitamin A supplementation. Therefore, these factors should be considered in policy formulation and programming in order to improve the coverage of vitamin A supplementation in Ethiopia. Keywords: Vitamin A supply, associated factors, multilevellogistic regression analysis, Ethiopia

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 >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 >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 Utilization of vitamin A supplementation services in high priority districts of Bihar

2018 ◽  
Vol 5 (2) ◽  
pp. 667
Author(s):  
Nivedita Sinha ◽  
Rajesh R. Sinha ◽  
Ajay Krishna ◽  
Rashmi Singh
Keyword(s):  
Public Health ◽  
Vitamin A ◽  
Observational Study ◽  
Health Problem ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Short Term ◽  
Cross Sectional ◽  
Vitamin A Supplementation ◽  
Ultimate Outcome

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. 

scholarly journals Vitamin A Supplementation Coverage and Ocular Signs among Children Aged 6–59 Months in Aleta Chuko Woreda, Sidama Zone, Southern Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Temesgen Nigusse ◽  
Achamyelesh Gebretsadik
Keyword(s):  
Health Education ◽  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Clinical Signs ◽  
Public Health Problem ◽  
Southern Ethiopia ◽  
Wealth Status ◽  
Health Development ◽  
Vitamin A Supplementation ◽  
Ocular Signs

Background. Periodic vitamin A supplementation to children is a cost-effective strategy to avert vitamin A deficiency. However, few pieces of evidence are available about the coverage of vitamin A supplementation at the community level in the study area. Therefore, the aim of this study was to assess vitamin A supplementation coverage and prevalence of ocular signs of vitamin A deficiency among children aged 6–59 months. Methods. Community-based cross-sectional study design was conducted using a two-stage stratified random sampling method. Data were collected from mothers with children aged 6–59 months using a structured pretested questionnaire. A total of 665 children aged 6 to 59 months were examined for clinical signs and symptoms of vitamin A deficiency by trained clinical health professionals. Descriptive statistics and logistic regression were done. Result. Vitamin A supplementation coverage in the study area was 36.2% (95% CI: 32.6–39.9). Overall, the prevalence of xerophthalmia was 2.7%. Age group 6–23 months (AOR: 2.1, 95% CI: 1.4–2.9), good maternal knowledge (AOR: 1.5, 95% CI: 1.2–2.1), children with high wealth status (AOR: 2.3, 95% CI: 1.4–3.8), precampaign health education on vitamin A (AOR: 3.4,95% CI: 2.1–5.6), member of Health Development Army (AOR: 2.7, 95% CI: 1.7–4.2), and access to health facility within <30 minutes (AOR: 2.5, 95% CI: 1.6–3.8) were significantly associated with the receipt of vitamin A capsule. Conclusion. Vitamin A supplementation coverage of the study area was low as compared to the UNICEF threshold of 70%. Vitamin A deficiency is a public health problem in the study area. Increasing maternal level of knowledge, precampaign health education on vitamin A supplementation, and strengthening Health Development Army are recommended to increase the vitamin A supplementation coverage.

scholarly journals Transgenic Pro-Vitamin A Biofortified Crops for Improving Vitamin A Deficiency and Their Challenges

2017 ◽  
Vol 11 (1) ◽  
pp. 11-23 ◽  
Author(s):  
Hyejin Lee
Keyword(s):  
Developing Countries ◽  
Vitamin A ◽  
Nutrition Education ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Current Status ◽  
Vitamin A Supplementation ◽  
Safety Issues ◽  
Crop Development ◽  
Significant Attention

Vitamin A Deficiency (VAD) has been a public health problem among children in developing countries. To alleviate VAD, Vitamin A Supplementation (VAS), food fortification, biofortification and nutrition education have been implemented in various degrees of success with their own merits and limits. While VAS is the most widely utilized intervention in developing countries to ease the burden of VAD, some have raised questions on VAS’ effectiveness. Biofortification, often touted as an effective alternative to VAS, has received significant attention. Among the available biofortification methods, adopting transgenic technology has not only facilitated rapid progress in science for enhanced pro-Vitamin A (pVA) levels in target crops, but drawn considerable skepticism in politics for safety issues. Additionally, VAD-afflicted target regions of transgenic pVA crops widely vary in their national stance on Genetically Modified (GM) products, which further complicates crop development and release. This paper briefly reviews VAS and its controversy which partly demanded shifts to food-based VAD interventions, and updates the current status of transgenic pVA crops. Also, this paper presents a framework to provide potential influencers for transgenic pVA crop development under politically challenging climates with GM products. The framework could be applicable to other transgenic micronutrient biofortification.

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 Vitamin A status and associated factors in infants attending at Primary Health Care in Goiânia, Goiás, Brazil

2015 ◽  
Vol 18 (2) ◽  
pp. 490-502 ◽  
Author(s):  
Lara Lívia Santos da Silva ◽  
Maria do Rosário Gondim Peixoto ◽  
Maria Claret Costa Monteiro Hadler ◽  
Sara Araújo da Silva ◽  
Fernanda Cobayashi ◽  
...  
Keyword(s):  
Vitamin A ◽  
Nutritional Status ◽  
Associated Factors ◽  
Maternal Education ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Linear Regression Models ◽  
Serum Retinol ◽  
Serum Retinol Concentration ◽  
Retinol Concentration

OBJECTIVE: This study aimed to assess the nutritional status of vitamin A and associated factors in children assisted in Primary Care Health in Goiânia, Goiás, Brazil. METHODS: This is a cross-sectional study with a sample of 228 children 12 to 16 months of age. The nutritional status of vitamin A was assessed by serum retinol concentration, determined by high performance liquid chromatography. Multiple linear regression models with hierarchical selection of independent variables were used to evaluate the correlation with serum retinol as the dependent variable. RESULTS: The vitamin A deficiency (retinol < 0,7 μmol/L) was observed in 14,0% of the children. Maternal schooling and hemoglobin concentration were positively correlated with serum retinol concentration, while C-reactive protein showed a negative correlation (R2 = 0,1648). CONCLUSION: The vitamin A deficiency in one-year-old children attended in Basic Health Units in Goiânia configures itself as a moderate public health problem. Actions to promote maternal education, morbidity control and prevention of other micronutrient deficiencies are important for prevention and control of the vitamin A deficiency in this population.

scholarly journals Nutritional Analysis of Vitamin A Enriched Bread from Orange Flesh Sweet Potato and Locally Available Wheat Flours at Samre Woreda, Northern Ethiopia

2013 ◽  
Vol 1 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Gebremedhin Kidane ◽  
Kebede Abegaz ◽  
Afework Mulugeta ◽  
Pragya Singh
Keyword(s):  
Vitamin A ◽  
Sweet Potato ◽  
Low Income ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Northern Ethiopia ◽  
Nutrition Research ◽  
Nutritional Analysis ◽  
Wheat Flours ◽  
Β Carotene

Vitamin A deficiency (VAD) is a public health problem in Ethiopia. Periodic supplementation of vitamin A (VA) capsules has developed as a short-term life saving intervention. However, it is important to shift from a subsidized periodic capsule distribution to a more sustainable food-based intervention, which could supply VA in the diet of low income rural communities. Orange flesh sweet potato (OFSP) was selected in this study as a potential raw material that used in food-based intervention, because of its high β-carotene content (naturally biofortified food). Therefore, this study aimed to analyze nutritional compostion of the VA enriched breads for pre-school children from OFSP and locally available Wheat flours of the study area. Blending of OFSP flour with whole Wheat flour (WWF) was conducted at laboratory by employing Complete Randomized Design (CRD). i.e. four bread blends of OFSP flour:WWF (0:100, 10:90, 20:80 and 30%:70%) were prepared and subjected to nutritional analysis at Ethiopian Health and Nutrition Research Institute (EHNRI). For proximate and β-carotene analysis AOAC (2000) standard method and manual column chromatography were used, respectively. The data were analyzed using SPSS, versions 16. Bread enriched with 30% OFSP flour can contribute 83.3 and 74.2% of VA to 3 and 4-6 years old children’s daily requirement, respectively. Therefore, WWF can be substituted by 30% OFSP flour for pre-school children’s bread making. A general trend of nutrient analysis showed that moisture, ash, fiber, β-carotene increased significantly (p < 0.05) as proportion of OFSP flour increased; while protein, fat, carbohydrate and energy content decreased. Therefore, OFSP flour enriched breads have added advantages nutritionally, especially in β-carotene. This will give responsible individuals, policymakers and donors more confidence to invest and work in OFSP for alleviation of VAD.

Fortification of Indonesian Unbranded Vegetable Oil: Public—Private Initiative, from Pilot to Large Scale

2012 ◽  
Vol 33 (4_suppl3) ◽  
pp. S301-S309 ◽  
Author(s):  
Soekirman ◽  
Damayanti Soekarjo ◽  
Drajat Martianto ◽  
Arnaud Laillou ◽  
Regina Moench-Pfanner
Keyword(s):  
Vitamin A ◽  
Vegetable Oil ◽  
Low Income ◽  
Large Scale ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Lessons Learned ◽  
Market Potential ◽  
National Standard ◽  
Cooking Oil

Background Despite improved economic conditions, vitamin A deficiency remains a public health problem in Indonesia. Objective This paper aims to describe the development of the Indonesian unbranded cooking oil fortification program and to discuss lessons learned to date and future steps necessary for implementation of mandatory, large-scale oil fortification with vitamin A. Methods An historic overview of the steps involved in developing the Indonesian unbranded cooking oil fortification program is given, followed by a discussion of lessons learned and next steps needed. Results Indonesia's low-income groups generally consume unbranded vegetable oil, with an average consumption of approximately 25 g/day. Unbranded oil constitutes approximately 70% of the total oil traded in the country. In 2007–10, a pilot project to fortify unbranded vegetable oil was carried out in Makassar, and an effectiveness study found that the project significantly improved the serum retinol concentrations of schoolchildren. In 2010, the pilot was expanded to two provinces (West Java and North Sumatra) involving the biggest two national refineries. In 2011, a draft national standard for fortified oil was developed, which is currently under review by the National Standard Body and is expected to be mandated nationally in 2013 as announced officially by the Government of Indonesia in national and international meetings. Conclusions Indonesia is a leading world supplier of cooking oil. With stakeholder support, the groundwork has been laid and efforts are moving forward to implement mandatory fortification. This project could encourage Indonesian industry to fortify more edible oils for export, thus expanding their market potential and potentially reducing vitamin A deficiency in the region.

The prevalence and associated factors of reduced bone mineral density (BMD) among men with suppressed viral load taking antiretroviral therapy

2021 ◽  
Vol 19 ◽  
Author(s):  
Safiye Nur Ozcan ◽  
Dilek Yıldız Sevgi ◽  
Ahsen Oncul ◽  
Alper Gunduz ◽  
Ozgun Pehlivan ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Viral Load ◽  
Bone Mineral ◽  
Associated Factors ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Mineral Density ◽  
Hiv Diagnosis

Background: Reduced bone mineral density (BMD) is a frequent comorbidity observed in people living with HIV (PLHIV). Objective: The aim of the study is to determine the prevalence and associated factors of reduced bone mineral density (BMD) among men with suppressed viral load taking antiretroviral therapy. Method: The study was conducted as a cross-sectional study design between January to April 2019. 211 patients were included in the study. Z-score at either body site between -1.0 and -2.0 or -2 or less were defined as osteopenia or osteoporosis, respectively. Multivariate logistic regression analysis was used to evaluate the factors affecting the development of reduced BMD. Results: The mean age of the patients involved in the study was 34.8 ± 7.6. Osteoporosis was detected in 21.4% and osteopenia in 44.5% of the patients. There was a significant relationship between HIV diagnosis time, ART usage duration, tenofovir disoproxil fumarate (TDF) use, TDF use in the past, total TDF usage time and decreased BMD. Multivariate logistic regression analysis showed that the likelihood of reduced bone marrow density was 67% lower among those with regular milk or dairy product intake compared to those without (OR=0.330; 95% CI = 0.12-0.92, p=0.033 ) Conclusion: There is a high prevalence of reduced BMD among PLHIV aged under 50 which is mainly confounded by HIV diagnosis time, ART usage duration and TDF usage. Although virological control has been achieved, these patients should be followed up, considering that they may have decreased BMD.

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