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VITAMIN A STUDY
Globally, 3 million children suffer clinical VAD (exhibiting the signs and symptoms of eye damage and xerophthalmia. However, the full magnitude of VAD often remains hidden: an estimated 140-250 million children under five years of age are at risk of sub-clinical VAD, mainly in Asia and Africa. Though showing none of the ocular signs or symptoms these children suffer a dramatically increased risk of death and illness, particuarly from measles and diarrhoea, as a consequence of VAD.
Long known to be a principle cause of childhood blindness (250 000-500 000 children lose their sight each year), VAD is now recognized as a major contributing factor in an estimated 1-3 million child deaths each year.
Benefits of Vitamin A Supplementation to Child Health
Vitamin A is essential for the functioning of the immune system and the healthy growth and development of children.
The simple provision of high-dose vitamin A supplements every 4-6 months not only protects against blindness but has been repeatedly shown to have a dramatic and multiple impact on the health of young children (6-59 months):
• Overall, all-cause mortality is reduced by 23%
• Measles mortality is reduced by 50%
• Diarrhoeal mortality is reduced by 33%
• 85% coverage can result in a 90% reduction in the prevalence of severe xerophthalmia
Note: coverage below 25% is unlikely to have an impact on xerophthalmia.
It is of interest to note that the 50% reduction in measles mortality is the same if vitamin A supplementation is given preventively (i.e. children's vitamin A levels are raised before they have measles) or as a treatment for measles case management. Given that many children with measles are never seen at health facilities the preventive strategy of supplementation can have the biggest health impact. For maximum health impact, programme managers should aim to reach at least 80% of children 6-59 months of age.
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Vitamin A supplementation has been shown to have a positive impact on child mortality, particularly with measles and diarrhoea:
Measles/Vitamin A studies have shown that supplementation:
• Enhances immune response
• Reduces the severity of measles
• Decreases the incidence and/or severity of major complications
(diarrhoea, pneumonia, croup or otitis media)
• Results in fewer days inhospital
• Leads to faster recovery and fewer post-measles complications
Diarrhoea/Vitamin A studies have shown that supplementation:
• Reduces the frequency of moderate and severe diarrhoea
• Results in fewer signs and symptoms of dehydration
• Lowers clinic attendance and the frequency of diarrhoea-related hospital admissions
Recent findings:
Vitamin A and Malaria: A recent study in Papua New Guinea found that when young children were given vitamin A supplements three times a year they had 30% fewer malaria attacks and the number of malaria parasites in their blood dropped by 36%.
Vitamin A and HIV/AIDS: Trials are currently on-going to determine if vitamin A supplementation can reduce the mother-to-child transmission of HIV during lactation.
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