Vitamin A deficiency (VAD) has been known to exist in Latin America and the Caribbean since the mid-1960s; however, except for pioneering work by the Institute of Nutrition of Central America and Panama/Pan American Health Organization on sugar fortification in Central America, there was little interest in controlling it because of the low frequency of clinical findings. More recently, implications of the effect of subclinical VAD on child health and survival has generated increased interest in assessing the problem and a greater commitment to controlling it. The information available by mid-1997 on the magnitude of VAD in countries of the Region was extensively reviewed. Internationally accepted methods and cutoff points for prevalence estimations were used to compile information from relevant dietary, biochemical, and clinical studies carried out between 1985 and 1997 in samples of at least 100 individuals. VAD in the Region of Latin America and the Caribbean is mostly subclinical. The national prevalence of subclinical VAD (serum retinol < 20 micrograms/dl) in children under 5 years of age ranges between 6% in Panama and 36% in El Salvador. The problem is severe in five countries, moderate in six, and mild in four. There are no recent data from Chile, Haiti, Paraguay, Uruguay, Venezuela, and the English-speaking Caribbean. The population affected amounts to about 14.5 million children under 5 years of age (25% of that age group). Schoolchildren and adult women may also have significant VAD. Actions currently implemented to control VAD include (a) universal or targeted supplementation, with sustained high coverage rates through national immunization days in some countries; (b) sugar fortification, which is well established in El Salvador, Guatemala, and Honduras (a significant effect has been documented in Guatemala and Honduras) and is under negotiation in Bolivia, Colombia, Costa Rica (to be resumed), Ecuador, Nicaragua, and Peru; and (c) limited dietary diversification activities.

A reference table of weight-for-height by week of pregnancy has been devised on theoretical grounds, based on the premises that the average increment of weight during pregnancy is 20% of the prepregnant weight and that almost all the increment takes place linearly during the 2nd and 3rd trimesters of pregnancy. The table was tested with retrospective clinic and hospital data. The results show a good correlation between the weight-for-height at different stages of pregnancy as a percentage of the reference table and the birth weight of the offsprings. This reference table can be a useful tool to assess the nutritional status of pregnant women and, within limits, to "predict" the chances of delivering a low birth weight infant.

No abstract

No abstract

An island-wide anemia survey was conducted in Jamaica on pregnant and lactating women and preschool age children. The results indicate that anemia is a serious public health problem in Jamaica. Of pregnant women, 61.6% had Hb levels below 11.0 g/dl. Of lactating women 58.7% had Hb levels below 12.0 g/dl. Of preschool age children 69.1% had Hb levels below 11.0 g/dl. Public health and fortification programs for the control of anemia have been implemented by the government and are currently being reviewed.