scholarly journals Co-implementing Vitamin A supplementation with Seasonal Malaria Chemoprevention in Sokoto State, Nigeria: a feasibility and acceptability study

Author(s):  
Olusola Oresanya ◽  
Abimbola Phillips ◽  
Ekechi Okereke ◽  
Abraham Ahmadu ◽  
Taiwo Ibinaiye ◽  
...  

Abstract BackgroundBi-annual high dose vitamin A supplements administered to children aged 6-59 months can significantly reduce child mortality, but vitamin A supplementation (VAS) coverage is low in Nigeria. The World Health Organization recommends that VAS be integrated into other public health programmes which are aimed at improving child survival. Seasonal malaria chemoprevention (SMC) provides a ready platform for VAS integration to improve health outcomes.MethodsA mixed methods study design was used to assess the feasibility and acceptability of co-implementing VAS with SMC in one local government area of Sokoto state in northern Nigeria. Existing SMC implementation tools and job aids were revised and community drug distributors, experienced in SMC delivery, were trained on the determination of VAS eligibility, administration of the correct doses and identification of adverse drug reactions. SMC and VAS were delivered using a door-to-door approach. VAS and SMC coverage were calculated and the outcome of the integration was assessed using questionnaires administered to 188 and 197 households at baseline and endline respectively. The Bowen framework was used to assess feasibility through focus group discussions and key informant interviews; thematic analysis was carried out on the qualitative data. ResultsAt endline, the proportion of children who received at least one dose of VAS in the last six months increased significantly from 2% to 59% (p<0.001). There were no adverse effects on the coverage of SMC delivery with 70% eligible children reached at baseline, increasing to 76% (p=0.412) at endline. There was no significant change (p=0.264) in the quality of SMC, measured by proportion of children receiving their first dose as directly observed treatment (DOT), at endline (68%) compared to baseline (54%). Study findings demonstrated acceptability among caregivers, community drug distributors, State and National healthcare officials. ConclusionThis study showed that it is feasible and acceptable to integrate VAS with SMC delivery in areas of high seasonal malaria transmission such as northern Nigeria, where SMC campaigns are implemented. SMC-VAS integrated campaign can significantly increase vitamin A coverage but more research is required to demonstrate the feasibility of this integration in different settings and on a larger scale.

2021 ◽  
Author(s):  
Olusola Oresanya ◽  
Abimbola Phillips ◽  
Ekechi Okereke ◽  
Abraham Ahmadu ◽  
Taiwo Ibinaiye ◽  
...  

Abstract Background Bi-annual high dose vitamin A supplements administered to children aged 6-59 months can significantly reduce child mortality, but vitamin A supplementation (VAS) coverage is low in Nigeria. The World Health Organization recommends that VAS be integrated into other public health programmes which are aimed at improving child survival. Seasonal malaria chemoprevention (SMC) provides a ready platform for VAS integration to improve health outcomes. Methods A mixed methods study design was used to assess the feasibility and acceptability of co-implementing VAS with SMC in one local government area of Sokoto state in northern Nigeria. Existing SMC implementation tools and job aids were revised and community drug distributors, experienced in SMC delivery, were trained on the determination of VAS eligibility, administration of the correct doses and identification of adverse drug reactions. SMC and VAS were delivered using a door-to-door approach. VAS and SMC coverage were calculated and the outcome of the integration was assessed using questionnaires administered to 188 and 197 households at baseline and endline respectively. The Bowen framework was used to assess feasibility through focus group discussions and key informant interviews; thematic analysis was carried out on the qualitative data. Results At endline, the proportion of children who received at least one dose of VAS in the last six months increased significantly from 2–59% (p<0.001). There were no adverse effects on the coverage of SMC delivery with 70% eligible children reached at baseline, increasing to 76% (p=0.412) at endline. There was no significant change (p=0.264) in the quality of SMC, measured by proportion of children receiving their first dose as directly observed treatment (DOT), at endline (68%) compared to baseline (54%). Study findings demonstrated acceptability among caregivers, community drug distributors, State and National healthcare officials. Conclusion This study showed that it is feasible and acceptable to integrate VAS with SMC delivery in areas of high seasonal malaria transmission such as northern Nigeria, where SMC campaigns are implemented. SMC-VAS integrated campaign can significantly increase vitamin A coverage but more research is required to demonstrate the feasibility of this integration in different settings and on a larger scale.


2020 ◽  
Vol 7 (1) ◽  
pp. 46-53
Author(s):  
Latifah Susilowati ◽  
Masta Hutasoit

Diarrhea is the leading cause of infant mortality in Indonesia. Data from the Bantul District Health Office showed that the diarrhea morbidity rate in 2015 was 4.57 per 1000 population. World Health Organization launched program to reduce morbidity and mortality due to pneumonia and diarrhea by recommending supplementation of vitamin A as an effort to maintain health since baby was born. The purpose of this study was to determine the correlation of vitamin A supplementation with the incidence of diarrhea in children aged 12 - 59 months in Kasihan 1 Public Health Center. This study was used case control design with a retrospective approach. The number of control and case group were 44 children of each. Researcher collected data of children aged 12 - 59 months who suffered diarrhea last 6 months then conducted a home visit to ask about the history of vitamin A supplementation in children. There was no statistically significant correlation between vitamin A supplementation and the incidence of diarrhea in children aged 12 - 59 months. Health workers especially nurses need to increase public awareness of vitamin A supplementation to children under five years old as a form of support for government program to prevent diarrhea.


2021 ◽  
Vol 10 ◽  
Author(s):  
Alessandro Miglietta ◽  
Annette Imohe ◽  
Andreas Hasman

Abstract Countries are increasingly transitioning from event-based vitamin A supplementation (VAS) distribution to delivery through routine health system contacts, shifting also to administrative, electronic-based monitoring tools, a process that brings certain limitations affecting the quality of administrative VAS coverage. At present, there is no standardised methodology for measuring the coverage of VAS delivered through routine health services. To address this gap, we conducted a systematic review of the literature to identify and recommend methods to measure VAS coverage, with the aim of providing guidance to countries on the collection of consistent data for planning, monitoring and evaluating VAS programmes integrated into routine health systems. We searched the PubMed®, Embase®, Scopus, Google Scholar and World Health Organization (WHO) Global Index Medicus databases for studies published from 1 January 2000 to 1 January 2021, reporting original data on VAS coverage and methodologies used for measurement. We screened 2371 original titles and abstracts, assessed twenty-seven full-text articles and ultimately included eighteen studies. All but two studies used a coverage cluster survey (CCS) design to measure VAS coverage, adapting the WHO Vaccination Coverage Cluster Surveys methodology, by modifying sample size and sampling parameters. Annual two-dose VAS coverage was reported from only four studies. Until electronic-based systems to collect and analyse VAS data are equipped to measure routine two-dose VAS coverage using administrative data, CCSs that comply with the 2018 WHO Vaccination Coverage Cluster Surveys Reference Manual represent the gold-standard method for effective VAS programme monitoring.


2007 ◽  
Vol 98 (2) ◽  
pp. 422-430 ◽  
Author(s):  
R. A. Ayah ◽  
D. L. Mwaniki ◽  
P. Magnussen ◽  
A. E. Tedstone ◽  
T. Marshall ◽  
...  

Postpartum vitamin A supplementation of mothers and infants is recommended, but the efficacy has been questioned. In this double-blind, placebo-controlled trial, Kenyan mother–infant pairs were randomised to maternal vitamin A (400 000 IU) or placebo < 24 h postpartum, and infant vitamin A (100 000 IU) or placebo at 14 weeks. Milk retinol was determined at weeks 4, 14 and 26, and maternal and infant serum retinol at weeks 14 and 26. Infant retinol stores were assessed at week 26, using a modified relative dose response (MRDR) test. Among 564 women, serum retinol at 36 weeks gestation was 0·81 (sd 0·21) μmol/l, and 33·3 % were < 0·7 μmol/l. Maternal serum retinol was not different between groups, but milk retinol was higher in the vitamin A group: (0·67 v. 0·60 μmol/l; 0·52 v. 0·44 μmol/l; 0·50 v. 0·44 μmol/l at 4, 14 and 26 weeks, respectively). When expressed per gram fat, milk retinol was higher in the vitamin A group only at 4 weeks. Infant serum retinol was not different between groups. However, although most infants had deficient vitamin A stores (MRDR>0·06 %) at 26 weeks, vitamin A to infants, but not mothers, resulted in a lower proportion of infants with deficient vitamin A stores (69 v. 78 %). High-dose postpartum vitamin A supplementation failed to increase serum retinol and infant stores, despite modest effects on milk retinol. Infant supplementation, however, increased stores. There is a need for a better understanding of factors affecting absorption and metabolism of vitamin A.


2012 ◽  
Vol 32 (4) ◽  
pp. 233-238 ◽  
Author(s):  
A M Nguyen ◽  
D S Grover ◽  
K Sun ◽  
V K Raju ◽  
R D Semba ◽  
...  

2019 ◽  
Vol 7 (1) ◽  
pp. 51
Author(s):  
Vika Gress Vio Dilita ◽  
Lucia Yovita Hendrati

Background: According to the World Health Organization (WHO), Indonesia is one of the ten countries with the most significant number of measles cases in the world. Immunization coverage in Trenggalek Regency has reached the target of prevention of measles in the elimination stage, namely measles immunization coverage> 95%, the incidence of measles persists and increases in the last three years, from 2013 to 2015. Purpose: This study aimed to evaluate the trends between measles immunization status and the provision of vitamin A with the incidence of measles in Trenggalek Regency. Methods: This type of research is an observational study with a cross-sectional study design. The sample population is consist of 14 sub-districts in Trenggalek Regency. Data was taken from the health profile of Trenggalek Regency in 2013, 2014, and 2015. In this study, data processing were analysed by Health Mapper application version 4.3.0.0 with product version 4.03 to determine data descriptively. Results: Distribution of measles incidence with immunization coverage in Trenggalek Regency in 2013, 2014, and 2015 showed that measles incidence tended to increase followed with the decreasing number of measles immunization coverage each year. Ironically, the distribution of measles incidence with vitamin A administration in 2013, 2014, and 2015 showed the incidence of measles had increased because of the inconsistent amount of vitamin A administration. Conclusion: Measles incidence tends to occur in low immunization coverage areas and has decreased from the previous year. Giving vitamin A does not prevent the occurrence of measles, but serves to reduce compilation.


2007 ◽  
Vol 86 (4) ◽  
pp. 1152-1159 ◽  
Author(s):  
Birgitte R Diness ◽  
Ane B Fisker ◽  
Adam Roth ◽  
Maria Yazdanbakhsh ◽  
Erliyani Sartono ◽  
...  

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.


Author(s):  
G Bhanuprakash Reddy ◽  
Raghu Pullakhandam ◽  
Santu Ghosh ◽  
Naveen K Boiroju ◽  
Shalini Tattari ◽  
...  

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.


2020 ◽  
Vol 9 (1) ◽  
pp. 71-80
Author(s):  
Eta Aprita Aritonang ◽  
Ani Margawati ◽  
Fillah Fithra Dieny

Latar Belakang : Beberapa faktor yang mempengaruhi terjadinya stunting anak usia 6-24 bulan antara lain kurangnya asupan zat gizi, penyakit infeksi, lingkungan, sosial ekonomi keluarga dan riwayat kehamilan ibu. Penelitian ini bertujuan menganalisis proporsi pengeluaran pangan rumah tangga, ketahanan pangan, dan asupan zat gizi sebagai faktor risiko terjadinya stunting usia 6-24 bulan.Metode : Penelitian ini menggunakan desain case-control dengan masing-masing kelompok kasus (stunting) dan kontrol (tidak stunting) berjumlah 24 sampel yang diambil menggunakan purposive sampling pada anak usia 6-24 bulan yang berada di Semarang Utara. Stunting diukur berdasarkan z-score tinggi badan menurut umur (TB/U) dianalisis dengan software World Health Organization (WHO) Anthro. Data yang diambil yaitu berat badan lahir, panjang badan lahir, tingkat pendidikan ibu, pendapatan keluarga dan pengeluaran rumah tangga. Data riwayat asupan energi, protein, vitamin A dan seng selama 1 tahun diperoleh dengan menggunakan Semi Quantitative Food Frequency Questionnaire (SQ-FFQ). Data ketahanan pangan diperoleh dengan menggunakan kuisioner Household Food Security Scale Module (HFSSM). Data dianalisis dengan menggunakan uji Chi Square dan analisis regresi logistik.Hasil : Baduta stunting lebih banyak mengalami kerawanan pangan rumah tangga (79,2%), riwayat kekurangan asupan protein (70,8%), vitamin A (75%) dan seng (66,7%) dibandingkan dengan anak yang tidak stunting. Ketahanan pangan rumah tangga (OR=6,9), riwayat asupan protein (OR=8,6), vitamin A (OR=20,6) dan seng (OR=8,7) merupakan faktor yang paling berisiko terhadap kejadian stunting pada baduta usia 6-24 bulan (p<0,05).Simpulan: Kerawanan pangan rumah tangga, kurangnya asupan protein, vitamin A dan seng merupakan faktor yang berisiko meningkatkan kejadian stunting pada baduta usia 6-24 bulan.


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