A Strategy for Scaling up Vitamin A Supplementation for Young Children in a Remote Rural Setting in Zimbabwe

Background. Vitamin A deficiency is a public health problem in Zimbabwe. Addressing vitamin A deficiency has the potential to enhance resistance to disease and reduce mortality especially in children aged 5 years.Objective. To describe a vitamin A supplementation outreach strategy implemented in one of the remote rural districts in Zimbabwe; which increased coverage after being implemented in difficult circumstances in a remote rural region.Methods. We implemented and adapted a vitamin A supplementation outreach strategy within the national immunisation days (NIDs) and extended programme of immunisation in a remote rural district in Zimbabwe. The strategy involved supplementating children at prescheduled outreach points once per month for the whole year. Despite usual operational challenges faced at implementation; this approach enabled the district to increase delivery of vitamin A supplements to young children in the district.Results. The strategy covered 63 outreach sites; with two sites being covered per day and visited once per month for the whole year. Coverage reached 71 in an area in which previous coverage rates were around 50.Conclusion. Implementing a vitamin A supplementation outreach strategy increased vitamin A supplementation coverage among children living in a remote rural region. This strategy can potentially be used by Scaling Up Nutrition (SUN) member states. However; we recommend further exploration of this strategy by others working in similar circumstances

The state of peadiatric eye care in Nigeria: a situational review and call for action

The fight against childhood blindness is being given top priority by the World Health Organization especially in regions of the world; like Nigeria where the gross income per capita is relatively low with up to 60.9 of them living in absolute poverty as at 2010. Avoidable causes of blindness in children needs to be eliminated through the development of sustainable and equitably distributed high quality children eye care services as part of our national health care system. However enough attention has not been given to achieve this yet. The purpose of this editorial is to highlight the challenges in childhood eye care in this country as well as discuss ways the current negative trend can be reversed

Conjunctival Impression Cytology and of Vitamin A Deficiency in Pregnant Women; Gondar; Northwest Ethiopia

Ethiopia has been classified by the WHO as a country where vitamin A deficiency is a public health problem. Vitamin A deficiency is labelled as a public health problem based on its extensively studied endemicity among children. Maternal vitamin A deficiency has received little attention. Thus the principal objective of this study is to assess the vitamin A status of pregnant Ethiopians based on Conjunctival Impression Cytology (CIC) and serum levels of vitamin A. It is a descriptive study done among women attending ANC in the second and third trimesters of pregnancy at the ante-natal clinic of Gondar University Hospital. Women who appeared in July to October 2006 were recruited into the study based on inclusion criteria. Their socio-demographic and economic status; dietary; anthropometric and maternity data were collected with the help of structured questionnaire. Fasting blood samples were taken from the antecubital vein of each woman for determination of serum retinol. Furthermore; conjunctival cell samples were collected on Millipore Cellulose Acetate Filter to detect vitamin A deficiency related to Goblet cells and squamous metaplasia.A total of 303 pregnant mothers were included in this study. Twenty-six percent of the pregnant women had vitamin A deficiency or low serum retinol. Night blindness was found in 4.3of the pregnant women. CIC results showed absence of goblet cells and/or mucin was seen more in those with low serum retinol but this was not statistically significant. Adequate nutrient supplementation to pregnant women is recommended based on the results. Further studies should be conducted to validate the importance of CIC

Consumer Acceptance of Yellow; Provitamin A-Biofortified Maize in Kwazulu-Natal

Objectives: To assess the acceptance of popular maize food products (phutu; thin porridge and samp); prepared with yellow; provitamin A-biofortified maize varieties; in 212 subjects between the ages of three and 55 years; from rural KwaZulu-Natal.Design: A cross-sectional study.Method: Preschool; primary school and secondary school subjects were randomly selected from two primary schools and one secondary school; respectively; while adult subjects constituted a convenience sample. Pre- and primary school children completed a paired preference test. Secondary school and adult subjects completed a five-point facial hedonic and a preference ranking test. Focus group discussions were conducted using adult subjects.Results: Preschool children preferred yellow maize to white maize food products: phutu (81 vs. 19; p-value 0.001); thin porridge (75 vs. 25; p-value 0.001) and samp (73 vs. 27; p-value 0.001). There was no statistically significant difference in preference for white and yellow maize by primary school children. Secondary school and adult subjects preferred white maize to yellow maize. Focus group discussions confirmed the preference for white maize by the adultsConclusion: The study findings suggest that yellow; provitamin A-biofortified maize has the potential to succeed as a new strategy of dealing with the serious problem of vitamin A deficiency; especially among children of preschool age. However; in older groups; this strategy is unlikely to be successful; unless other strategies are implemented; including intensive nutrition education programmes on the nutritional benefits of the maize; targeting the market price at which yellow maize is sold; increasing its availability in local grocery stores; and improving its sensory properties through breeding

Assessment of Vitamin A Supplementation Coverage and its Association with Childhood Illness in Boloso Sore Woreda; Welayta Zone; SNNP Region; Ethiopia

Background: Vitamin A plays vital role in the physiology of vision and immunity. Globally quarters of a billion children are Vitamin A deficient. Vitamin A supplementation of children and mothers during postpartum period is a key strategy to avert the deficiency. However the effect of Vitamin A supplementation on incidence of childhood illnesses is controversial. Objective: To assess the effect of Vitamin A supplementation on the reduction of common childhood illnesses; and to measure the coverage of vitamin A supplementation among children aged 6-59 months and mothers during postpartum period. Methods: A retrospective cohort study which involves comparison between Vitamin A supplemented and nonsupplemented children was conducted in Feb 2008 in Boloso Sore Woreda; Wolayta Zone; SNNPR. A total of 1601 children aged 6-59 months were selected using Probability Proportional to Size (PPS) sampling technique. Results: Vitamin A supplementation coverage among children (6-59 months) was 83.1and among women (in postpartum period) who had given birth in the preceding 12 months of the survey was 13.2. In comparison with the corresponding level in 2005; the coverage in the area has increased significantly (P0.05). Most of the vitamin A supplementation coverage was achieved through Enhanced Outreach Strategy. Vitamin A supplementation status was not significantly associated with history of Fever [AORCI 0.89-1.77)]; Cough or rapid breathing/difficulty in breathing [AOR=1.15 (95CI 0.77-1.72)]; Eye infection [AOR=1.22 (95CI 0.78-1.89)]; and Diarrhea [AOR=0.98 (95CI 0.64-1.52)]. Recommendations: The effect of Vitamin A supplementation on reduction of childhood illnesses should be assessed through longitudinal studies among Vitamin A deficient children

Manifestations oculaires liees a la carence en vitamine A en zone rurale du Burkina Faso

Le deficit en vitamine A est responsable de cecite crepusculaire ou hemeralopie; de xerophtalmie et peut aboutir a la cecite. Au Burkina Faso; les etudes realisees dans differentes regions ont montre la gravite de la situation mais la methodologie utilisee ne permet pas d'extrapoler des resulats obtenus a l'ensemble du pays. La notion d'hemeralopie a ete dans un premier temps recherchee chez 466 enfants ages de 6 a 14 ans et a ete notee chez 14 d'entre eux soit une prevalence de 3 p. 100 dans cette tranche d'age. Dans un second temps; au sein d'un echantillon de 281 sujets de tous ages issus de 30 familles du village selectionnees de facon aleatoire; la prevalence de l'hemeralopie etait de 3;9 p; 100 (6 p. 100 chez les enfants ages de 2 a 5 ans). L'examen clinique a montre qu'une xerophtalmie etait presente chez 7 p. 100 des sujets examines. La frequence de celle-ci a diminue de moitie apres la saison des mangues pour devenir nulle apres administration d'une capsule de 200000 UI de vitamine A. Sur 8 cas de cecite recenses; 5 etaient d'origine onchocerquienne et 2 etaient lies a la carence en vitamine A. Ces donnees soulignent la place importante de cette carence dans la survenue de manifestations oculaires severes au Burkina Faso et la necessite d'une prevention

The Impact of vitamin A deficiency on childhood morbidity and mortality

Vitamin A deficiency is one of the greatest public health problems in tropical and subtropical regions. In Uganda; the intake of vitanin A is based on vegetables. Indeed adequate vitamin A helps the body to maintain resistance to several diseases. So to reduce morbidity and mortality of children vitamin A supplements should be given to them

Control of vitamin A deficiency in Africa

This paper presents a brief summary of vitamin A deficiency and xerophthalmia in Africa; and an overview of strategies for prevention and control. Indeed the epidemiological picture is complex in all dimensions. 18-20 countries in Sub-Saharan or Sahelian zones are estimated to have vitamin A deficiency problem of public health dimensions; and in a few more it is sporadically or occasionally present. Distribution of vitamin A supplements would be organized quite widely in Africa; especially in times of drought and emergencies

Development of vitamin A control programs : an exemple from Tanzania

This article describes the rationale for starting vitamin A deficiency control programs and the experience from Tanzania on starting such programs. The objective is to draw lessons which could be applied elsewhere as countries move towards the elimination of vitamin A deficiency by the year 200. The successful development and implementation of sustainable national vitamin A programs is possible even in poor countries like Tanzania; provided that there is a political will

Lower Shire Valley ocular disease survey: report on nutritional status and general morbidity

The primary objective of the survey was to provide a baseline data on the magnitude of the problem; the principle causes of blindness and their geographical distribution within the valley which can be utilized in the planning of health and nutrition programs for communities in the Lower Shire Valley

Essential micro-nutrients supplementation project; 1990-1992

The overall goal of the programme is to fight three major components of malnutrition in Malawi (iodine deficiency disorders; nutritional anemias and vitamin A deficiency)

National project for prevention of vitamin A deficiency: project document

Proposal for a 10 year project to eliminate Vitamin A deficiency as a public health problem