scholarly journals High dose vitamin A capsules – Rusty bullets?

2017 ◽  
Vol 8 (1) ◽  
pp. 52
Author(s):  
Ane B Fisker ◽  
Ted Greiner
Keyword(s):  
Vitamin A ◽  
Low Income ◽  
Vitamin A Deficiency ◽  
Scale Up ◽  
Low Income Countries ◽  
High Dose ◽  
Magic Bullet ◽  
Vitamin A Status ◽  
The Impact ◽  
High Dose Vitamin

High-dose vitamin A capsules (HDVAC) are distributed to preschool children in low-income countries on the assumption that they reduce mortality and treat vitamin A deficiency. As for other so-called magic bullet approaches, donors and policy makers consider their large-scale distribution highly cost-effective. Consequently, other ways to improve vitamin A status have received less attention; both donors and governments assume HDVAC are doing most of what needs to be done. Yet, the only evidence for an effect on mortality comes from 25-year-old studies and this effect no longer appears to be substantial. Surprisingly, impact evaluations have been absent. The only study that might be considered an effectiveness or impact evaluation found HDVAC had no effect in northern India. It is not widely appreciated that the impact of HDVAC on vitamin A status is limited, temporary and not cumulative over time. Nor can it be given to women except immediately after giving birth, and thus it is an inappropriate intervention for tackling vitamin A deficiency. To ensure that we use limited resources wisely, we need to identity and scale up strategies which combat vitamin A deficiency and reduce mortality.

scholarly journals Road Safety in Low-Income Countries: State of Knowledge and Future Directions

2019 ◽  
Vol 11 (22) ◽  
pp. 6249 ◽  
Author(s):  
Shahram Heydari ◽  
Adrian Hickford ◽  
Rich McIlroy ◽  
Jeff Turner ◽  
Abdulgafoor M. Bachani
Keyword(s):  
Low Income ◽  
Traffic Engineering ◽  
Road Safety ◽  
Scale Up ◽  
Safety Data ◽  
Low Income Countries ◽  
Future Research ◽  
Improvement Programs ◽  
Behavioural Aspects ◽  
The Impact

Road safety in low-income countries (LICs) remains a major concern. Given the expected increase in traffic exposure due to the relatively rapid motorisation of transport in LICs, it is imperative to better understand the underlying mechanisms of road safety. This in turn will allow for planning cost-effective road safety improvement programs in a timely manner. With the general aim of improving road safety in LICs, this paper discusses the state of knowledge and proposes a number of future research directions developed from literature reviews and expert elicitation. Our study takes a holistic approach based on the Safe Systems framework and the framework for the UN Decade of Action for Road Safety. We focused mostly on examining the problem from traffic engineering and safety policy standpoints, but also touched upon other sectors, including public health and social sciences. We identified ten focus areas relating to (i) under-reporting; (ii) global best practices; (iii) vulnerable groups; (iv) disabilities; (v) road crash costing; (vi) vehicle safety; (vii) proactive approaches; (viii) data challenges; (ix) social/behavioural aspects; and (x) capacity building. Based on our findings, future research ought to focus on improvement of data systems, understanding the impact of and addressing non-fatal injuries, improving estimates on the economic burden, implementation research to scale up programs and transfer learnings, as well as capacity development. Our recommendations, which relate to both empirical and methodological frontiers, would lead to noteworthy improvements in the way road safety data collection and research is conducted in the context of LICs.

Promoting vitamin A status in low-income countries

The Lancet ◽  
1999 ◽  
Vol 353 (9163) ◽  
pp. 1458-1459 ◽  
Author(s):  
Suzanne M Filteau ◽  
Andrew M Tomkins
Keyword(s):  
Vitamin A ◽  
Low Income ◽  
Low Income Countries ◽  
Vitamin A Status

scholarly journals National immunisation days and vitamin A distribution in Mali: has the vitamin A status of pre-school children improved?

2003 ◽  
Vol 6 (3) ◽  
pp. 233-240 ◽  
Author(s):  
JF Schémann ◽  
A Banou ◽  
D Malvy ◽  
A Guindo ◽  
L Traore ◽  
...  
Keyword(s):  
Vitamin A ◽  
Mass Distribution ◽  
School Children ◽  
Vitamin A Deficiency ◽  
Public Health Problem ◽  
Cross Sectional ◽  
National Immunisation ◽  
Vitamin A Status ◽  
The Status ◽  
The Impact

AbstractObjective:The impact on vitamin A status of the distribution of vitamin A during national immunisation days (NIDs) has not been well established despite strong promotion by international agencies and donors. Using a pre–post design, the change in prevalence of vitamin A deficiency was examined in pre-school children in Mali.Design:Two cross-sectional surveys were conducted in Mopti region, the first in March 1997 before this strategy was adopted and the second in March 1999, four-and-a-half months after a mass distribution of vitamin A during NIDs.Subjects and setting:We compared the vitamin A status of children aged 12 to 66 months targeted in 1999 by NIDs with the status of children in the same age group in 1997. Infectious events of the previous two weeks were concurrently recorded. Within the 1999 sample, the status of recipient and non-recipient children was also compared.Results:In 1997, the prevalence of xerophthalmia (defined by the presence of night blindness and/or Bitot spots) was 6.9% (95% confidence interval (CI) 5.1–9.2) and the modified retinol dose response (MRDR) test proved abnormal in 77.8% of 12–66-month-old children (95% CI 68.27–85.17). In 1999 this picture had improved significantly, both for xerophthalmia prevalence, 3.3% (95% CI 2.1–5.2), and abnormal MRDR test response, 63.1% (95% CI 54.25–71.23). The infectious morbidity rates between 1997 and 1999 tended to decrease. No significant improvement was found among children older than those targeted by NIDs. In 1999, children who received vitamin A had a lower risk for xerophthalmia (3.0% for recipients vs. 8.7% for non-recipients) and experienced fewer infectious events.Conclusions:The clinical and biological vitamin A status of pre-school children improved between 1997 and 1999. Mass distribution of vitamin A appears to reduce the occurrence of xerophthalmia and would seem to be associated with a decrease in other related illnesses. Vitamin A supplementation during NIDs should be given a high priority when vitamin A deficiency remains a public health problem.

scholarly journals Impact of high‐dose vitamin A supplements on vitamin A status of 3‐4 y old Zambian boys

2006 ◽  
Vol 20 (5) ◽  
Author(s):  
Emmanuel Aklamati ◽  
Kenneth H Brown ◽  
Modest Mulenga ◽  
Emmanuel Kafwembe ◽  
Janet M Peerson ◽  
...  
Keyword(s):  
Vitamin A ◽  
High Dose ◽  
Vitamin A Status ◽  
High Dose Vitamin

scholarly journals Night Blindness in Cystic Fibrosis: The Key Role of Vitamin A in the Digestive System

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1876 ◽  
Author(s):  
Lorenzo Norsa ◽  
Laura Zazzeron ◽  
Marialaura Cuomo ◽  
Laura Claut ◽  
Anna Marta Clotilde Bulfamante ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Liver Disease ◽  
Vitamin A ◽  
Low Income ◽  
Vitamin A Deficiency ◽  
Intestinal Failure ◽  
Intestinal Resection ◽  
Low Income Countries ◽  
Cholestatic Liver Disease

Vitamin A is a fundamental micronutrient that regulates various cellular patterns. Vitamin A deficiency (VAT) is a worldwide problem and the primary cause of nocturnal blindness especially in low income countries. Cystic fibrosis (CF) is a known risk factor of VAD because of liposoluble vitamin malabsorption due to pancreatic insufficiency. We describe a case of a 9-year-old girl who experienced recurrent episodes of nocturnal blindness due to profound VAD. This little girl is paradigmatic for the explanation of the key role of the gut–liver axis in vitamin A metabolism. She presents with meconium ileus at birth, requiring intestinal resection that led to a transient intestinal failure with parenteral nutrition need. In addition, she suffered from cholestatic liver disease due to CF and intestinal failure-associated liver disease. The interaction of pancreatic function, intestinal absorption and liver storage is fundamental for the correct metabolism of vitamin A.

High Dose Vitamin A Supplementation of Breast-Feeding Indonesian Mothers: Effects on the Vitamin A Status of Mother and Infant

1993 ◽  
Vol 123 (4) ◽  
pp. 666-675 ◽  
Author(s):  
Rebecca J. Stoltzfus ◽  
Mohammad Hakimi ◽  
Kevin W. Miller ◽  
Kathleen M. Rasmussen ◽  
Siti Dawiesah ◽  
...  
Keyword(s):  
Vitamin A ◽  
Breast Feeding ◽  
High Dose ◽  
Vitamin A Supplementation ◽  
Vitamin A Status ◽  
High Dose Vitamin

scholarly journals The Effect of Chronic High Dose Vitamin a Supplementation on Lipid Metabolism in Adipose Tissue (P02-013-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kieran Finney ◽  
Anthony Oxley ◽  
Catherine Winder ◽  
Andrew Southam ◽  
Andris Jankevics ◽  
...  
Keyword(s):  
Gene Expression ◽  
Adipose Tissue ◽  
Lipid Metabolism ◽  
Vitamin A ◽  
Mitochondrial Dysfunction ◽  
High Dose ◽  
Serum Samples ◽  
Hypervitaminosis A ◽  
The Impact ◽  
High Dose Vitamin

Abstract Objectives The objective of this study was to assess the impact of high-dose vitamin A (VA) on lipid metabolism. Previously, VA has been shown to enhance fat mobilisation, leading to a reduction in body fat. We hypothesise that hypervitaminosis A will increase expression of genes associated with lipid catabolism. Methods To induce chronic hypervitaminosis A, two groups of pigs (n = 8) were fed a commercial diet. The treatment group was additionally dosed, daily, with an oral supplement of retinyl propionate of 10,000 µg/KgBW for 17 weeks. To assess the impact of VA on lipid metabolism, a microarray analysis was performed to identify gene expression in adipose tissue. Differentially expressed transcripts and pathways were identified using Genespring and mapped to human orthologues for Ingenuity Pathway Analysis (IPA); gene fold changes were confirmed using qRT-PCR. Additionally, an untargeted UPLC-MS lipidomic analysis was carried out in serum samples to identify changes in lipd classes and their metabolites. Results In dosed animals, significant increases in plasma retinol (0.66 μmol/L) and liver retinyl ester concentrations (11.98 μmol/g both P < 0.001), as well as an increase in serum NEFA of 92.84 μmol/L (P = 0.001) were observed. Gene expression fold changes in subcutaneous adipose tissue were related to mitochondrial dysfunction and lipid metabolism, including increased expression of MT-CYTB (↑4.78x, P < 0.05) and ATP5A1 (↑3.13x, P < 0.05). Metabolomics confirmed changes in lipids and their metabolites relevant to adipose tissue in blood (P = 0.05), namely a decrease in triacylglyceride concentration and increases in acyl carnitine and cardiolipin concentrations. Conclusions An integrated pathway is suggested to explain the role of vitamin A in leading to increased lipolysis, β-oxidation and oxidative phosphorylation, but when in excess, markers of mitochondrial dysfunction were observed. Funding Sources Funded by the Bill and Melinda Gates foundation.

Carotenoid-Rich Bananas: A Potential Food Source for Alleviating Vitamin A Deficiency

2003 ◽  
Vol 24 (4) ◽  
pp. 303-318 ◽  
Author(s):  
Lois Englberger ◽  
Ian Darnton-Hill ◽  
Terry Coyne ◽  
Maureen H. Fitzgerald ◽  
Geoffrey C. Marks
Keyword(s):  
Vitamin A ◽  
Food Source ◽  
Vitamin A Deficiency ◽  
Food Sources ◽  
Carotenoid Content ◽  
Potential Food Source ◽  
Vitamin A Status ◽  
The World ◽  
The Impact ◽  
Potential Food

This review article points out that bananas are an important food for many people in the world. Thus, banana cultivars rich in provitamin A carotenoids may offer a potential food source for alleviating vitamin A deficiency, particularly in developing countries. Many factors are associated with the presently known food sources of vitamin A that limit their effectiveness in improving vitamin A status. Acceptable carotenoid-rich banana cultivars have been identified in Micronesia, and some carotenoid-rich bananas have been identified elsewhere. Bananas are an ideal food for young children and families for many regions of the world, because of their sweetness, texture, portion size, familiarity, availability, convenience, versatility, and cost. Foods containing high levels of carotenoids have been shown to protect against chronic disease, including certain cancers, cardiovascular disease, and diabetes. Because the coloration of the edible flesh of the banana appears to be a good indicator of likely carotenoid content, it may be possible to develop a simple method for selecting carotenoid-rich banana cultivars in the community. Research is needed on the identification of carotenoid-rich cultivars, targeting those areas of the world where bananas are a major staple food; investigating factors affecting production, consumption, and acceptability; and determining the impact that carotenoid-rich bananas may have on improving vitamin A status. Based on these results, interventions should be undertaken for initiating or increasing homestead and commercial production.

scholarly journals A Cross-Sectional Survey of Vitamin A Deficiency and the Associated Risk Factors among the Children of District Gujrat, Punjab, Pakistan

2020 ◽  
Vol 2 (3) ◽  
pp. 46-59
Author(s):  
Adil Hussain ◽  
Safa Rafique ◽  
Sana Batool ◽  
Saman Hina ◽  
Malik Siddique Mahmood
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Vitamin A ◽  
Low Income ◽  
Urban Areas ◽  
Vitamin A Deficiency ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Associated Risk Factors ◽  
The Impact

Vitamin A deficiency (VAD) is a very common problem in developing countries and in extreme situations, it is responsible for vision impairment as well as death. To conduct a comprehensive cross-sectional evaluation of the deficiency of vitamin A and the associated risk factors responsible for its deficiency, a questionnaire based survey was conducted in District Gujrat, Punjab, Pakistan. In order to evaluate the data related to VAD and its relationship with different variables, a cross-sectional survey was conducted of 400 female students from three different schools in District Gujrat. The schools were situated in both rural and urban areas. A questionnaire eliciting personal information, family status and diet related information was used to collect the required data for the survey. The results did not pertain with the participants’ gender. The results were based on the summer season routine of diet and physical activity. All information was sorted and the results were analyzed using the Microsoft Excel 2010 update and SPSS version 20. It was found that 39% girls (156 out of 400) were deficient in vitamin A. The main source of VAD was found to be inadequate dietary consumption. It was also found that children with poor socioeconomic standing, low fluid consumption, and from urban areas have more VAD than others. Moreover, the age group of 8-11 years carried a higher percentage of VAD, while physical activity had no impact on VAD. A large number of girls were reported as the victims of VAD due to poverty and related socioeconomic constraints prevailing among the school going children in District Gujrat. A crucial approach towards reducing VAD is to learn about the preventive measures to control VAD. In low-income countries, the use of vitamin A supplements with daily diet is required to reduce the impact of VAD.

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