ABSTRACT
The Ministry of Health in Sri Lanka commenced a vitamin A supplementation programme of school children with a megadose of 105 micromol (100,000 IU) vitamin A in school years 1, 4 and 7 (approximately 5-, 9- and 12-year-olds, respectively) in 2001. We evaluated the vitamin A supplementation programme of school children in a rural area of Sri Lanka. A cross-sectional study was conducted among children supplemented with an oral megadose of vitamin A (105 micromol; n 452) and children not supplemented (controls; n 294) in Grades 1-5. Children were clinically examined and a sample of blood was taken for serum vitamin A concentration estimation by HPLC. Socio-demographic information was obtained from children or mothers. Supplemented children had a higher proportion of males and stunted children, were younger and lived under poorer conditions as compared to controls. There was no difference in the prevalences of eye signs and symptoms of vitamin A deficiency in the two groups. Supplemented children had higher serum vitamin A concentrations than controls (1.4 (SD 0.49) micromol/l v. 1.2 (SD 0.52) micromol/l). The serum vitamin A concentrations were 1.6 (SD 0.45), 1.4 (SD 0.50), 1.3 (SD 0.44) and 1.1 (SD 0.43) micromol/l in children supplemented within 1, 1-6, 7-12 and 13-18 months of supplementation, respectively. Vitamin A concentrations were significantly greater than controls if supplementation was carried out within 6 months after adjustment. The oral megadose of 105 micromol vitamin A maintained serum vitamin A concentrations for 6 months in school children.
Subject(s)
Vitamin A Deficiency/drug therapy , Vitamin A/administration & dosage , Vitamins/administration & dosage , Chi-Square Distribution , Child , Cross-Sectional Studies , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Male , Morbidity , Nutritional Requirements , Nutritional Status , Regression Analysis , Social Class , Sri Lanka , State Medicine , Time Factors , Treatment Outcome , Vitamin A/blood , Vitamin A Deficiency/blood , Vitamins/bloodABSTRACT
The objective of this study was to determine the impact of Vitamin A supplementation on health status and absenteeism of school children. A randomized double blind placebo controlled trial over a period of 13 months was conducted in a rural area of Sri Lanka involving 613 school children attending Grades 1-5 (aged 5 to 13 years). Children were assigned to either 200,000 IU of Vitamin A (n=297) or placebo (n=316) once every 4 months. Socio-demographic data were obtained at baseline, and anthropometry and haemoglobin concentrations were assessed at baseline and post intervention. Serum vitamin A concentrations were assayed by HPLC in a subgroup of children (n=193) before administration of each dose. School absenteeism was recorded. The two groups of children were similar at baseline in all variables. The subgroup of children was comparable to the main study population. The prevalence of vitamin A deficiency (< 20 microg/dL) in the subgroup of children was 8.2%. Changes in anthropometric indices and haemoglobin concentrations were similar in the two groups. The major causes for absenteeism were non-health causes and supplemented children lost a fewer number of school days due to illness than placebo children (p=0.053). Vitamin A concentrations improved with each dose and the improvement was greater with better compliance. Vitamin A supplementation with 200,000 IU every 4 months over 13 months improved vitamin A status and school attendance but not anthropometric status of these children.
