Impact of Massive Doses of Vitamin a on Incidence of Nutritional Blindness

Delivery of oral doses of vitamin a to prevent vitamin a deficiency and nutritional blindness

“…Assuming that cases and controls broadly represent their respective populations "at large" of malnourished children in these slums, this study provides the first quantifiable estimate of risk protection against severe xerophthalmia conferred by a 200,000 IU dose of vitamin A. Moreover, incidence of corneal xerophthalmia, measured by monitoring hospitalized cases from study areas, decreased more than four-fold from 0.47 to 0.10 per 1,000 per year in distribution areas during the four-year study, while incidence in nonprogram slums varied between 0.80 to 0.60 per 1,000 during this same time period (114).…”

“…Recently, Indian investigators have concluded a four-year, hospital-based, case-control study of the efficacy of 200,000 IU of vitamin A given every six months to prevent corneal xerophthalmia (114). Children with X2/X3 (n = 32) and their nutritional status-matched controls (n = 99) from 375 slums in Hyderabad and Secunderabad were questioned about their previous receipt of at least one large dose of vitamin A during the previous year in the community.…”

“…The population prophylactic efficacy measure (e ) can be used to further evaluate the vitamin A distribution program being carried out by the National Institute of Nutrition in the urban slums of Hyderabad, India (114). The casecontrol-derived prophylactic efficacy (e) against X2/X3 associated with receipt of at least one capsule during the previous year was 92.5%.…”

“…Community concern has at times been expressed about the potential for workers' hands or the use of a single spoon as vehicles for disease transmission while administering oral doses of vitamin A (17,23). In the Hyderabad project (114), this problem has been partially resolved by transferring the 2 ml dosage to the mother's spoon whenever possible (149). A possible solution to both the above spillage and hygienic problems is to use a properly calibrated 5 ml dropper or syringe to administer concentrate from a small bottle.…”

Three Decades of the Integrated Child Development Services Program in India: Progress and Problems

“…To test whether large doses of vitamin A supplements prevented keratomalacia, a case-control analysis was done, with patients with severe protein-energy malnutrition being used as controls. The high odds ratio clearly indicated that keratomalacia was more likely to occur in children not receiving supplements (Vijayaraghavan et al, 1984) …”