Effect of vitamin A supplementation on cause-specific mortality in women of reproductive age in Ghana: a secondary analysis from the ObaapaVitA trial

Hurt, Lisa; Asbroek, Augustinus ten; Amenga‐Etego, Seeba; Zandoh, Charles; Danso, Samuel; Edmond, Karen; Hurt, Chris; Tawiah, Charlotte; Hill, Zelee; Fenty, Justin; Owusu‐Agyei, Seth; Campbell, O.; Kirkwood, Betty

doi:10.2471/blt.11.100412

Cited by 7 publications

(7 citation statements)

References 19 publications

(26 reference statements)

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“…However, there was a considerable difference in the rate of use of oral rehydration reported in demographic and health surveys: from 26.0% in India to 77.6% in Bangladesh. 12 , 13 , 15 – 19 , 21…”

Section: Resultsmentioning

confidence: 99%

“…For Ghana, data were available on all infants aged 1 to 11 months who were enrolled in a vitamin A trial. 12 For India, only infants aged 1 to 11 months from the control arm of the Integrated Management of Neonatal and Childhood Illness trial were included because the trial intervention could have affected the risk of death due to diarrhoea. 13 Neonates were not included because their clinical presentation was different and limited data were available.…”

Section: Methodsmentioning

confidence: 99%

“…Households were visited every 4 weeks and the single most important cause of death was assigned by physicians. 12 …”

Section: Methodsmentioning

confidence: 99%

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Childhood diarrhoeal deaths in seven low- and middle-income countries

Rahman

Moinuddin

Molla

et al. 2014

Bull. World Health Organ.

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ObjectiveTo investigate the clinical characteristics of children who died from diarrhoea in low- and middle-income countries, such as the duration of diarrhoea, comorbid conditions, care-seeking behaviour and oral rehydration therapy use.MethodsThe study included verbal autopsy data on children who died from diarrhoea between 2000 and 2012 at seven sites in Bangladesh, Ethiopia, Ghana, India, Pakistan, Uganda and the United Republic of Tanzania, respectively. Data came from demographic surveillance sites, randomized trials and an extended Demographic and Health Survey. The type of diarrhoea was classified as acute watery, acute bloody or persistent and risk factors were identified. Deaths in children aged 1 to 11 months and 1 to 4 years were analysed separately.FindingsThe proportion of childhood deaths due to diarrhoea varied considerably across the seven sites from less than 3% to 30%. Among children aged 1–4 years, acute watery diarrhoea accounted for 31–69% of diarrhoeal deaths, acute bloody diarrhoea for 12–28%, and persistent diarrhoea for 12–56%. Among infants aged 1–11 months, persistent diarrhoea accounted for over 30% of diarrhoeal deaths in Ethiopia, India, Pakistan, Uganda and the United Republic of Tanzania. At most sites, more than 40% of children who died from persistent diarrhoea were malnourished.ConclusionPersistent diarrhoea remains an important cause of diarrhoeal death in young children in low- and middle-income countries. Research is needed on the public health burden of persistent diarrhoea and current treatment practices to understand why children are still dying from the condition.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Childhood diarrhoeal deaths in seven low- and middle-income countries

Rahman

Moinuddin

Molla

et al. 2014

Bull. World Health Organ.

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“…It is therefore important to note that South Africa adopted the WHO recommendation and stopped VAS for postpartum women in 2011 . Results from the ObaapaVitA trial in rural Ghana corroborated the evidence that low‐dose VAS does not have a beneficial effect on reducing mortality in women of reproductive age . Nevertheless, other important interventions that form part of the INP that have shown promise in reducing nutrient deficiencies in the country are the Food Fortification Programme (FFP), a compulsory government initiative that mandates millers to fortify staple foods (such as the maize meal and flour) with essential nutrients including vitamin A, and the National School Nutrition Programme, a state‐funded nutritional program that delivers cooked breakfast or lunch consisting of a starch, a protein, and a vegetable to all quintile 1–3 primary schools nationally.…”

Section: Introductionmentioning

confidence: 86%

“…13,14 Results from the ObaapaVitA trial in rural Ghana corroborated the evidence that low-dose VAS does not have a beneficial effect on reducing mortality in women of reproductive age. 15 Nevertheless, other important interventions that form part of the INP that have shown promise in reducing nutrient deficiencies in the country are the Food Fortification Programme (FFP), 16 a compulsory government initiative that mandates millers to fortify staple foods (such as the maize meal and flour) with essential nutrients including vitamin A, and the National School Nutrition Programme, 17 a state-funded nutritional program that delivers cooked breakfast or lunch consisting of a starch, a protein, and a vegetable to all quintile 1-3 primary schools nationally. After undertaking research on the burden of disease attributed to vitamin A in South Africa in the year 2000, Nojilana et al supported the notion that the FFP will also contribute to the reduction in the morbidity and mortality associated with VAD in South Africa.…”

Section: Introductionmentioning

confidence: 99%

The impact of sociodemography, diet, and body size on serum retinol in women 16–35 years of age: SANHANES‐1

Parker

Mchiza

Sewpaul

et al. 2017

Annals of the New York Academy of Sciences

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To determine the current vitamin A status of a nationally representative sample of women aged 16-35 years, compare it with previous national data, and determine the impact of sociodemography, diet, and body size on vitamin A status, we performed secondary analysis of data on South African women who participated in the first South African National Health and Nutrition Examination Survey (SANHANES-1). Vitamin A status was assessed by serum retinol, and the findings are reported as means and prevalences with corresponding 95% confidence intervals. Overall, the age-standardized vitamin A deficiency prevalence was 11.7%, a decrease from previous national data, but serum retinol levels remained lower than in other developing countries. Overall, unweighted, multilevel, multivariate logistic regression showed that vitamin A deficiency was influenced by race only (odds ratio (OR) = 1.89, P = 0.031), while weighted multiple logistic regression for 16-to 18-year-olds showed that vitamin A deficiency was influenced by locality (OR = 9.83, P = 0.005) and household income (intermediate (OR = 0.2, P = 0.022) and upper (OR = 0.25, P = 0.049)). Despite the decreased prevalence, vitamin A deficiency remains a moderate public health problem in the country. Opportunities for targeted interventions have been identified.

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Vitamin A supplementation during pregnancy for maternal and newborn outcomes

McCauley

Broek

Dou

et al. 2010

Cochrane Database of Systematic Reviews

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Analysis 1.1. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 1 Maternal mortality.. .. Analysis 1.2. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 2 Perinatal mortality.. .. Analysis 1.3. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 3 Neonatal mortality.. .. Analysis 1.4. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 4 Stillbirth.. .. .. . Analysis 1.5. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 5 Maternal anaemia.. .. Analysis 1.6. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 6 Maternal clinical infection. Analysis 1.7. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 7 Maternal night blindness.. Analysis 1.8. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 8 Preterm birth.. .. .. Analysis 1.9. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 9 Neonatal anaemia.. .. Analysis 1.12. Comparison 1 Vitamin A alone versus placebo or no treatment, Outcome 12 Low birthweight.. . .

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Effect of vitamin A supplementation on cause-specific mortality in women of reproductive age in Ghana: a secondary analysis from the ObaapaVitA trial

Cited by 7 publications

References 19 publications

Childhood diarrhoeal deaths in seven low- and middle-income countries

Childhood diarrhoeal deaths in seven low- and middle-income countries

The impact of sociodemography, diet, and body size on serum retinol in women 16–35 years of age: SANHANES‐1

Vitamin A supplementation during pregnancy for maternal and newborn outcomes

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