Impact of Vitamin A Supplementation on Xerophthalmia

Djunaedi, Edi; Sommer, Alfred; Pandji, A; Kusdiono,; Taylor, Hugh R.

doi:10.1001/archopht.1988.01060130228033

Cited by 39 publications

(11 citation statements)

References 18 publications

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“…Thus, a xerophthalmia prevalence of 0.4% among preschoolers from a national survey in 1992 (Muhilal et al, 1994) was adopted for schoolers. This estimate is likely to be conservative, given a well-known trend for the prevalence of mild xerophthalmia to rise with age at least into the early school years (Sommer, 1982;Djunaedi et al, 1988;Muhilal et al, 1994), a lack of any VA supplementation program for this age group, and probably adverse nutritional effects from a national economic crises during the past decade.…”

Section: Methodsmentioning

confidence: 99%

Vitamin A deficiency and xerophthalmia among school-aged children in Southeastern Asia

Singh

West

2004

Eur J Clin Nutr

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Objective: To determine provisional estimates of the extent of vitamin A (VA) deficiency and xerophthalmia among school-aged children. Design: Literature search of published, unpublished and website-based population survey and study reports, with countryspecific imputation of prevalence rates and numbers of children affected by: (1) VA deficiency based on measured or imputed distributions of serum retinol concentration o0.70 mmol/l (equivalent to o20 mg/dl) and (2) xerophthalmia, by country. Setting: Countries within the WHO South-East Asian Region. Subjects: The target group for estimation was children 5-15 y of age. Interventions: None. Results: The estimated prevalence of VA deficiency is 23.4%, suggesting that there are B83 million VA-deficient school-aged children in the region, of whom 10.9% (9 million, at an overall prevalence of 2.6%) have mild xerophthalmia (night blindness or Bitot's spot). Potentially blinding corneal xerophthalmia appears to be negligible at this age. Conclusions: VA deficiency, including mild xerophthalmia, appears to affect large numbers of school-aged children in SouthEast Asia. However, nationally representative data on the prevalence, risk factors and health consequences of VA deficiency among school-aged children are lacking within the region and globally, representing a future public health research priority.

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Section: Methodsmentioning

confidence: 99%

Vitamin A deficiency and xerophthalmia among school-aged children in Southeastern Asia

Singh

West

2004

Eur J Clin Nutr

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“…(126) While not strictly program effectiveness, the prevalence of night blindness in Indonesian communities receiving vitamin A supplements during the Aceh trial fell by 82 percent from baseline to follow-up, compared with a 49 percent drop in control villages where only children presenting with ocular signs were supplemented. (127) Lack of vital events registries in most affected countries prevents programs from directly tracking trends in child mortality in the presence of program activity. One analysis utilized Nepal's 2001, Demographic and Health Survey to explore the relationship between supplementation coverage and child mortality.…”

Section: Effectivenessmentioning

confidence: 42%

A Quarter of a Century of Progress to Prevent Vitamin A Deficiency Through Supplementation

Palmer

West

2010

Food Reviews International

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A quarter of century has passed since FRI published its first comprehensive review on vitamin A deficiency (VAD) and its prevention. At the time, the major impetus to prevent VAD was to reduce xerophthalmia in preschool children. Today, we have a broader understanding of the public health implications of VAD, with disorders including xerophthalmia, mortality, severe infection, and anemia in preschool children and pregnant women. While deficiency affects most developing countries, nearly half of all deficient children and women live in Southern Asia. Prevention has made substantial strides. High potency vitamin A supplementation (with 200,000 IU) remains a prophylactic mainstay, delivered through fixed facilities, enhanced outreach activities, and national child health day campaigns twice annually. Surprisingly, the costs of semi-annual delivery of vitamin A have changed little over the years, with new cost estimates remaining comparable to earlier figures of US ~$0.50 per child per year. Emerging is the potential to reduce infant mortality by ~20% in Southern Asia by giving a single, oral, 50,000 IU dose of vitamin A to newborns. While ~500 million vitamin A capsules are routinely distributed worldwide each year to achieve effective control, progress has been slower with efforts to improve diet on a purposeful global public health scale. Future advances through effective dietary diversification and various means of food fortification will be required before periodic supplementation can be phased down as a major population strategy for controlling vitamin A deficiency.

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“…Deficiency of this vitamin results in morphological changes in the epithelial surfaces of all parts of the body, including the eye. 18 However, we can conclude that history of no night blindness can be used as a criteria to identify those community members who do not have vitamin A deficiency and a luxometer reading is essential to serve as an objective assessment of night blindness. Vitamin A deficiency is often seen in developing countries and occurs primarily in children of school age.…”

Section: Discussionmentioning

confidence: 99%

“…A finding in Indonesia showed that night blindness ceased to be an accurate reflection of xerophthalmia impact when the prevalence was low. 18 However, we can conclude that history of no night blindness can be used as a criteria to identify those community members who do not have vitamin A deficiency and a luxometer reading is essential to serve as an objective assessment of night blindness. Bitot's spots were seen in 2.8% of the children, compared with 1.7 and 0.4% in Western Yemen and Thailand, respectively.…”

Section: Discussionmentioning

confidence: 99%

Ocular manifestation of vitamin A deficiency among Orang Asli (Aborigine) children in Malaysia

Ngah

Moktar

Isa

et al. 2002

Asia Pac J Clin Nutr

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This study determined the prevalence of ocular manifestation of vitamin A deficiency in Orang Asli (Aborigine) children. Night blindness was found in 16.0% of the children, conjunctiva xerosis in 57.3%, Bitot's spot in 2.8%, corneal xerosis in 0.5% and corneal scars in 5.6%. These findings show that history of night blindness had sensitivity, specificity and predictive value (positive) of 47.2, 98.1 and 96.2%, respectively, compared with the standard diagnosis procedure using luxometer readings.

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Impact of Vitamin A Supplementation on Xerophthalmia

Cited by 39 publications

References 18 publications

Vitamin A deficiency and xerophthalmia among school-aged children in Southeastern Asia

Vitamin A deficiency and xerophthalmia among school-aged children in Southeastern Asia

A Quarter of a Century of Progress to Prevent Vitamin A Deficiency Through Supplementation

Ocular manifestation of vitamin A deficiency among Orang Asli (Aborigine) children in Malaysia

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