Increased risk of respiratory disease and diarrhea in children with preexisting mild vitamin A deficiency

Sommer, Alfred; Katz, Joanne; Tarwotjo, Ignatius

doi:10.1093/ajcn/40.5.1090

Cited by 434 publications

(178 citation statements)

References 20 publications

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“…Vitamin A deficiency is widespread in developing countries, particularly in young children and women where it is an important cause of immune function impairment (Semba, 1994) and increased risk of morbidity and mortality from infectious and other diseases (Fawzi et al, 1993;Sommer et al, 1984;West et al, 1999). The main causes of vitamin A deficiency are inadequate intake of vitamin A-rich foods such as liver, full milk, butter, eggs, whole fish, green leafy vegetables and yellow-orange fruits, as well as increased requirements due to a high burden of infectious diseases.…”

Section: Introductionmentioning

confidence: 99%

Effects on serum retinol of multi-micronutrient supplementation and multi-helminth chemotherapy: a randomised, controlled trial in Kenyan school children

et al. 2002

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Objective: To assess the effects of multi-micronutrient supplementation and multi-helminth chemotherapy on serum retinol concentration, using schools as a health delivery system. Study area and population: From 19 primary schools in Bondo District, western Kenya, 977 children between 9 and 18 y were included in the trial. The 644 (65.9%) children on whom baseline serum retinol was available were included in this study. Design: A randomised, placebo-controlled, double-blind, two-by-two factorial trial on the effects of multi-micronutrient supplementation and multi-helminth chemotherapy on serum retinol after 8 months. Intervention: Single treatment with albendazole (600 mg) and praziquantel (40 mg=kg of body weight) and daily multimicronutrient supplementation with tablet containing 1000 mg vitamin A. Results: Micronutrient supplementation (0.08 mmol=l, 95% CI 0.01, 0.14; P ¼ 0.025), but not treatment (0.03 mmol=l, 95% CI 7 0.04, 0.10; P ¼ 0.38), increased serum retinol. However, treatment did increase serum retinol in S. mansoni-infected (0.09, 95% CI 0.02, 0.16; P ¼ 0.009), but not in uninfected children ( 7 0.07, 95% CI 7 0.18, 0.03; P ¼ 0.18; interaction, P ¼ 0.01). Similarly, reduction in egg output of S. mansoni, but none of the geohelminth, was a predictor, corresponding to a 0.008 mmol=l (95% CI 0.00002, 0.02; P ¼ 0.049) increase in serum retinol per 100 epg reduction. Interestingly, interactions were found between age and sex (P ¼ 0.046), and malaria parasitaemia and sickle cell phenotype (P ¼ 0.04). Conclusion: Multi-micronutrient supplementation and reduction in S. mansoni egg output increased serum retinol, irrespective of initial serum retinol.

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Section: Introductionmentioning

confidence: 99%

Effects on serum retinol of multi-micronutrient supplementation and multi-helminth chemotherapy: a randomised, controlled trial in Kenyan school children

et al. 2002

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“…The ocular signs of VAD include night blindness, conjunctival xerosis, Bitot spots, corneal ulceration, keratomalacia and total blindness. Several studies have revealed that there is a positive association between VAD and increased respiratory infections (2,3) , diarrhoea, measles and childhood mortality (4)(5)(6)(7)(8)(9) . VAD compromises the immune system in 40 % of children in the developing world and contributes to one million deaths of young children each year (10,11) .…”

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confidence: 99%

Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India

Laxmaiah

Nair

Arlappa

et al. 2011

Public Health Nutr.

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Objective: To assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children. Design: A community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure. Setting: Rural areas of eight states in India. Subjects: Pre-school children and their mothers were covered. Results: A total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0?8 %. The total ocular signs were significantly higher (P , 0?001) among boys (2?6 %) compared with girls (1?9 %) and in older children (3-4 years) compared (P , 0?001) with younger (1-2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR 5 3?8; 95 % CI 2?9, 5?0), labourers (OR 5 2?9; 95 % CI 2?1, 3?9), illiterate mothers (OR 5 2?7; 95 % CI 2?2, 2?3) and households without a sanitary latrine (OR 5 5?9; 95 % CI 4?0, 8?7). Subclinical VAD (serum retinol level ,20 mg/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %. Conclusions: The study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.

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“…According to Indonesia's national vitamin A survey in 1992, more than 50% of the under-®ve children had a marginal vitamin A status (Muhilal et al, 1994). Children with vitamin A de®ciency are at increased risk of blindness and death, and illness is generally more severe and lasts longer (Sommer et al, 1984;Beaton et al, 1993;Ghana VAST Study Team, 1993). Recently, a study in Nepal found that maternal mortality was reduced by 40 ± 50% when women were supplemented with a weekly low dose of vitamin A or b-carotene (West et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

The potential of various foods to serve as a carrier for micronutrient fortification, data from remote areas in Indonesia

Melse‐Boonstra¹,

Pee²,

Martini³

et al. 2000

Eur J Clin Nutr

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Objective: To estimate the potential of various industrially produced foods, to serve as a carrier for micronutrient forti®cation based on the frequency of their consumption in different socio-economic strata; to determine the role of forti®ed instant noodles as a source of micronutrients; to assess the contribution of plant foods, animal foods and forti®ed foods to vitamin A intake. Setting: A survey was conducted in rural South Sulawesi and urban South Kalimantan between November 1996 and January 1997. Subjects: Households (1500 in South Sulawesi; 2112 in South Kalimantan) were selected randomly by multistage cluster sampling. From each household, data were collected from the mother and her youngest child (0 ± 5 y). Data collection: Mothers were interviewed on various topics, including socio-economic status, food consumption, receipt of high-dose vitamin A capsules, health and nutritional status. Results: Monosodium glutamate and salt were consumed daily in almost all households in both areas, and consumption was not associated with socio-economic status. Instant noodles were consumed in nearly all households in both areas, but consumption of forti®ed noodles was related to socio-economic status; it was highest among households of government employees and private investors, and lowest among farmers and sharecroppers. Vegetables were the most important source of vitamin A in rural South Sulawesi, while foods of animal origin were the most important source in urban South Kalimantan. Conclusions: The results support double or triple forti®cation of salt andaor monosodium glutamate with iodine, vitamin A andaor iron. Efforts to overcome associated technical and logistical dif®culties are urgently needed.

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Increased risk of respiratory disease and diarrhea in children with preexisting mild vitamin A deficiency

Cited by 434 publications

References 20 publications

Effects on serum retinol of multi-micronutrient supplementation and multi-helminth chemotherapy: a randomised, controlled trial in Kenyan school children

Effects on serum retinol of multi-micronutrient supplementation and multi-helminth chemotherapy: a randomised, controlled trial in Kenyan school children

Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India

The potential of various foods to serve as a carrier for micronutrient fortification, data from remote areas in Indonesia

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