Mass supplementation of vitamin A linked to National Immunization Day.

OBJECTIVE: Main objectives were to assess the feasibility of linking vitamin A delivery with National Immunization Days (NIDs) and to see the impact on xerophthalmia. METHODS: An Intervention study of mass distribution of vitamin A solution was undertaken to control widespread xerophthalmia prevalent in children living in about 26 slums of Chandigarh in the year 2000. Two rounds of mass distribution of Vitamin A solution covering 27642 and 31762 children in 1-5 years of age in first and second rounds, respectively, were undertaken. The findings of second round and post evaluation after intervention are presented here. An additional team of two persons per pulse polio immunization (PPI) centre delivered age specific doses of vitamin A solution through 98 centres and operational problems were recorded. PPI staff provided the supervision and PPI tally sheets were used. RESULTS: The programme achieved a vitamin A coverage rate of 99% in first round and 88% in second round. Only two parents refused vitamin A solution. No side effect or cases of toxicity due to vitamin A were reported by health institutions in the area or in a stratified random sample of 101 children. There was a significant decline (13.4%) in xerophthalmia after two rounds of mass distribution (P < .001). The strategy to deliver vitamin A was successfully integrated into NID's and appeared to achieve a significant decline in xerophthalmia. CONCLUSION: Linking of vitamin A distribution with PPI could be a basis for launching similar initiatives in other areas of India and other countries where xerophthalmia is a public health problem.

Rapid assessment and delivery of Vitamin A to slum children by using National Immunization Day in Chandigarh.

This study was done with the objective to see the feasibility of using National Immunization Days (NIDs) for rapid assessment, and delivery of Vitamin A solution to about 27,600 children dwelling in 26 slums in Union Territory of Chandigarh. The assessment of Vitamin A deficiency (VAD) was done in a stratified random sample of 1304 children during third round of Intensified Pulse Polio Immunization (IPPI) and delivery of Vitamin A solution was done during fourth round of IPPI in 1999-2000 covering 27,642 children in the age group of 1-5 years. An additional team of two persons per centre delivered age specific doses of Vitamin A solution through 72 centres and operational problems were recorded. IPPI staff provided supervision and same tally sheets as of IPPI were used. The prevalence rate of VAD was 24.6%, with conjunctival xerosis, bitot's spot and corneal xerosis as 23.7%, 0.6% and 0.2% respectively. 27,275 (98.7%) children out of 27,642 were administered Vitamin A solution, with no major operational problem. Only five parents (0.01%) refused Vitamin A solution. No case of side effect or toxicity due to Vitamin-A was reported. The strategy to assess and deliver Vitamin A during NID's was found to be feasible and successful and could be a basis for launching similar initiatives in other areas of India and other countries where VAD is a public health problem.

Deficiencia de vitamina A: frecuencia y características clínicas en dos poblaciones del Estado de Chiapas / Deficiency of vitamina A: frequency and clinic characteristics in two populations in Chiapas

Introducción. La deficiencia de vitamina A ha sido bien reconocida como un problema de salud pública en el mundo. Existen pocos estudios en nuestro país acerca de la seroprevalencia de deficiencia de esta vitamina. Los objetivos de este estudio fueron: a) determinar la prevalencia de deficiencia de vitamina A en niños menores de cinco años de edad, de dos poblaciones chiapanecas, b) establecer que relación existe entre los niveles séricos de retinol con signos clínicos de deficiencia de vitamina A, estado nutricional (de acuerdo a peso y talla) e historia de hábitos nutricionales. Material y métodos. Se realizó un estudio transversal en dos en dos poblaciones, una rural y otra urbana del estado de Chiapas. El cuestionario de recolección de datos incluyó: datos antropométricos del niño, evaluación clínica de éstos y los resultados de la serología sobre retinol. Se contempló la posibilidad de administrar vitamina A (200,000 UI por dosis) a todos aquellos niños que mostraran deficiencia. Resultados. La prevalencia de hipovitaminosis A en la población estudiada fue del 25 por ciento. No existieron nihiperqueratosis ni xeroftalmia. Los datos sobre el estado nutricional revelaron la presencia de una desnutrición leve a moderada en ambas poblaciones. Conclusiones. El cálculo de la ingesta de retinol contenido en la dieta diaria, mostró una ingesta muy baja de este último, todo lo cual hace suponer que los hábitos dietéticos inadecuados pudieran ser la principal causa de la deficiencia de vitamina; por lo tanto los programas de educación nutricional son muy importantes en estas poblaciones

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