Vitamin A supplementation on child morbidity.

OBJECTIVE: To determine the impact of vitamin A supplementation on child morbidity and nutritional status. DESIGN: A community based follow-up (interventional) in nature. SETTING: Two randomly selected Weredas (districts) of Tigray, North Ethiopia were studied between 1996 and 1997. SUBJECTS: Four thousand seven hundred and seventy children aged between six and 72 months, selected using a multi-stage sampling procedure were enrolled and clinically assessed for xerophthalmia and nutritional status. A sub-sample of these children (n = 281) was further assessed for their serum retinol levels. MAIN OUTCOME MEASURES: The pre and post intervention data on xerophthalmia, morbidity, nutritional status and serum retinol levels were compared. RESULTS: Vitamin A capsule coverage of 87% in all the villages of the Weredas and a statistically significant (p < 0.05) reduction in the prevalence of Bitot's spot (from 1.5 to 0.5), fever (from 29.8 to 14.2), diarrhoea (from 30.2 to 18.2), oedema (from 9.2 to 3.2), measles (from 14.0 to 6.2), conjunctivitis (from 10.2 to 3.0), stunted (from 64.2 to 42.7), wasted (from 12.8 to 2.5) and underweight (from 46.2 to 24.2). The proportion of children with normal serum retinol concentration (> 0.7 micromole/L) has also improved significantly (from 36.8 to 56.2). CONCLUSION: In conclusion, the significant improvement in morbidity and nutritional status that followed the intervention programme although encouraging, it still indicates the importance of coupling periodic provision of Vitamin A capsules with nutrition education.

The effect of varying doses of oral iodized oil in the prophylaxis of endemic goitre in elementary schools children.

The effect of oral iodine supplementation on total goitre rate (%TGR) and urinary iodine excretion among school children 4 to 16 years of age was studied. In the first group (n = 57) 200mg oral iodized oil reduced %TGR from 31.6% to 17.5% and 33.3% to 24.6% in males and females respectively, while in the second group (n = 53), 400mg iodine reduced the %TGR from 34.0% to 20.8% in males and 35.9% to 24.5% in females after 13 months of intervention. This gave a relative indication that the 200mg is as effective as the 400mg in goitre reduction. In subsequent tests, the maximum urinary iodine excretion was obtained from the groups which received two doses of iodized oil 24 hours after the intervention. A significant (p = 0.003) greater increase in urinary iodine excretion was noted at 24 hours among both male and female children administered 400mg than among those who received 200mg. Measurements after 24 hours showed no significant difference between urinary iodine excretion of the two dose groups. These results suggest that: (i) 200mg is likely equally effective as 400mg for iodine deficiency disorders control and prevention among children and (ii) iodine could be administered annually rather than biannually.

Patterns of goitre in Sidama Awraja in Ethiopia and its relationship to piped water supply.

A cross sectional study was conducted in 1987 to determine the extent of goitre in Awassa Zuria part of Sidama Awraja. Households were the subjects of the survey to assess goitre rates. Trained staff were used for interview and clinical assessment of goitre rate. Among the total of 2,450 study population surveyed, 83.9% (n = 2,055) were school children. Out of the total study population, 40.5% (n = 993) were positive for goitre and ninety eight cases of the positive school children (n = 791) were randomly taken for biochemical tests. The Radio immunoassay technique was used to measure the levels of T3, T4 and TSH. The Sandell and Kolthoff technique was used to measure urine and water iodine. A comparison of T4 results, showed higher results for surface water users than piped water users and this has shown a significant difference (P < 0.001). It was higher in piped water compared to surface water. Further investigation however is required to fully elucidate the picture. Generally it is advisable to start iodine prophylaxis program in the studied areas.