Vitamin A capsule distribution to control vitamin A deficiency in Indonesia: effect of supplementation in pre-school children and compliance with the programme

Pangaribuan, Rosnani Verba; Erhardt, Juergen; Scherbaum, Veronika; Biesalski, Hans Konrad

doi:10.1079/phn2002418

Cited by 23 publications

(14 citation statements)

References 19 publications

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“…Vitamin A-deficient children who were given 100 000 IU vitamin A every 2 weeks for 3 months significantly increased serum vitamin A level as compared with vitamin A-deficient children given placebo. These data were consistent with the results of a prospective cohort study by Pangaribuan et al (2003) in Indonesia, in which the proportion of children with lower serum vitamin A concentration decreased from 18.8 to 14.5% by receiving a single dose of 200 000 IU vitamin A. However, our study differed from that study in that all the vitamin A-deficient-supplemented children in our study increased their serum vitamin A level (data not shown) and the follow-up mean serum vitamin A level of them even reached the normal level as compared with vitamin A-sufficient children.…”

Section: Discussionsupporting

confidence: 92%

Effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency in China

et al. 2007

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Objective: To clearly clarify the protective effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency. Methods: Three hundred sixty-two children in two kindergartens in Wuhan China were enrolled. Detailed dietary assessment and anthropometry were undertaken to facilitate the exclusion of malnourished children. Seventy vitamin A-deficient children with informed consent were randomly divided into the vitamin A-deficient-supplemented group and vitamin A-deficient placebo group, 35 vitamin A-sufficient children (age-and sex-matched with the vitamin A-deficient-supplemented group children) were selected as vitamin A-sufficient placebo group. The baseline and follow-up level of selected immune parameters of the 105 children in three intervention groups were compared. Results: The total proportion of severe and marginal vitamin A-deficient children was 10.9 and 21.96%, respectively. At baseline, the serum complement C3 and sIgA level of vitamin A-sufficient children was significantly higher than that of vitamin A-deficient children (Po0.05). However, the serum lysozyme level of vitamin A-sufficient children was inversely lower. After intervention, vitamin A-deficient-supplemented children increased serum vitamin A, complement C3 and sIgA level, but their serum lysozyme level inversely decreased. Conclusions: Vitamin A deficiency was still a serious health problem in children in China cities. Vitamin A supplementation was efficacious in ameliorating serum vitamin A status and partially impaired immune function of well-nourished children suffering from vitamin A deficiency.

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Section: Discussionsupporting

confidence: 92%

Effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency in China

et al. 2007

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“…Previous studies among Indonesian children support our findings and reported significant improvements in Hb concentration among vitamin A-supplemented children compared to control children [36,37]. The increments were much higher when vitamin A was distributed together with albendazole tablets in children infected with A .…”

Section: Discussionsupporting

confidence: 89%

“…However, this reduction was only significant in the prevalence of IDA among vitamin A-supplementedchildren ( p < 0.01), and this supports the significant impact of vitamin A on Hb concentration and iron status indices. Among Indonesian preschool children, a significant decrease in the proportion of anaemia among recipients of vitamin A supplements (200,000 IU) from 25.7% to 15.3% was reported after two months, whereas the proportion did not show a significant change after supplementation in non-recipients [36]. Moreover, combined vitamin A and iron supplementation were shown to reduce anaemia more effectively [41].…”

Section: Discussionmentioning

confidence: 99%

Effects of Vitamin A Supplementation on Iron Status Indices and Iron Deficiency Anaemia: A Randomized Controlled Trial

et al. 2013

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Iron deficiency anaemia (IDA) is the most common nutritional deficiency in the world including developed and developing countries. Despite intensive efforts to improve the quality of life of rural and aboriginal communities in Malaysia, anaemia and IDA are still major public health problems in these communities particularly among children. A randomized, double-blind, placebo-controlled trial was conducted on 250 Orang Asli (aboriginal) schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on iron status indices, anaemia and IDA status. The effect of the supplement was assessed after 3 months of receiving the supplements; after a complete 3-day deworming course of 400 mg/day of albendazole tablets. The prevalence of anaemia was found to be high: 48.5% (95% CI = 42.3, 54.8). Moreover, 34% (95% CI = 28.3, 40.2) of the children had IDA, which accounted for 70.1% of the anaemic cases. The findings showed that the reduction in serum ferritin level and the increments in haemoglobin, serum iron and transferrin saturation were found to be significant among children allocated to the vitamin A group compared to those allocated to the placebo group (p < 0.01). Moreover, a significant reduction in the prevalence of IDA by almost 22% than prevalence at baseline was reported among children in the vitamin A group compared with only 2.3% reduction among children in the placebo group. In conclusion, vitamin A supplementation showed a significant impact on iron status indices and IDA among Orang Asli children. Hence, providing vitamin A supplementation and imparting the knowledge related to nutritious food should be considered in the efforts to improve the nutritional and health status of these children as a part of efforts to improve the quality of life in rural and aboriginal communities.

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“…Interestingly, although ,40 % of children had low SROL at both contacts, none tested positive for low liver stores (29) . Of the remaining five studies listed in Table 2, all showed an initial rightward shift in the SROL distribution and a roughly 25 % (mean, weighted by study size) decrease in the proportion of deficient children (SROL , 0?70 mmol/l) in the first 2 months post-dosing (31)(32)(33)(34)(35) . SROL concentrations measured at later time points in Mexico, the Philippines (Fig.…”

Section: Resultsmentioning

confidence: 99%

The use and interpretation of serum retinol distributions in evaluating the public health impact of vitamin A programmes

Palmer

West

Dalmiya

et al. 2012

Public Health Nutr.

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Objective: Developing countries have adopted universal, high-potency vitamin A (VA) supplementation and food fortification as major strategies to control deficiency, prevent nutritional blindness and reduce child mortality. Yet questions persist regarding how best to measure impact and when to phase out supplementation. The present paper provides guidance on the use and interpretation of serum retinol (SROL) distributions as indicators of both programme impact and adequate VA intake in a population. Design: We reviewed extant data on SROL's response to high-potency VA supplementation and VA-fortified foods in children. Results: Supplementation virtually eliminates xerophthalmia and reduces child mortality; however, it shifts the SROL distribution only transiently (,2 months). Regular consumption of VA-fortified foods prevents xerophthalmia, lowers mortality and sustainably improves SROL distributions, from which both compliance and public health impact can be inferred. Conclusions: Given SROL's limited responsiveness to high-potency VA supplementation, target population coverage remains the preferred performance indicator. However, periodic SROL surveys do reflect underlying dietary risk and can guide programming: low or marginal SROL distributions in areas with high supplementation coverage do not signify programme failure, but rather suggest the need to continue supplementation while working to effectively raise dietary VA intakes. We propose that a sustained rise in the SROL distribution, defined as #5 % prevalence of SROL , 0?70 mmol/l among vulnerable population groups in at least two consecutive surveys ($1 year apart), be used as an indicator of stable and adequate dietary VA intake and status in a population, at which point programmes may re-evaluate the need for continued universal supplementation.

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Vitamin A capsule distribution to control vitamin A deficiency in Indonesia: effect of supplementation in pre-school children and compliance with the programme

Cited by 23 publications

References 19 publications

Effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency in China

Effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency in China

Effects of Vitamin A Supplementation on Iron Status Indices and Iron Deficiency Anaemia: A Randomized Controlled Trial

The use and interpretation of serum retinol distributions in evaluating the public health impact of vitamin A programmes

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