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

Abstract

Approximately 8 to 10 million new cases of xerophthalmia due to vitamin A deficiency occur each year, with as many as ½ to 1 million children developing potentially blinding corneal disease. While vitamin A deficiency is the leading cause of blindness among children in developing countries, even milder states of deficiency carry an increased risk of morbidity and mortality, making its prevention a major public health priority. Three basic preventive strategies exist: (1) dietary modification through a variety of horticultural and nutrition education techniques to increase the routine availability and consumption of food sources of vitamin A, (2) fortification of a centrally processed, locally available and consumed food

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

“…(104) Use of fortification as the primary means to control vitamin A deficiency faces similar impediments today as those cited 25 years ago. (1) Namely, its implementation is limited in most affected countries by lack of commercially processed, fortifiable foods that are broadly available, affordable, and consumed by those at greatest risk of deficiency. (1) While there have been efforts by non-governmental organizations in Sub Saharan Africa to promote fortification by small-scale millers, sugar fortification in Central America continues to serve as the best example of sustainable food fortification with vitamin A.…”

“…(1) Namely, its implementation is limited in most affected countries by lack of commercially processed, fortifiable foods that are broadly available, affordable, and consumed by those at greatest risk of deficiency. (1) While there have been efforts by non-governmental organizations in Sub Saharan Africa to promote fortification by small-scale millers, sugar fortification in Central America continues to serve as the best example of sustainable food fortification with vitamin A. (105) The most significant progress made over the past two decades has been in the scale up and institutionalization of vitamin A supplementation, which serves as the focus for the remainder of this review.…”

“…Community education campaigns linked with vitamin A supplementation were just emerging at the time of the previous article, largely tied to longer-term goals of increasing the consumption of vitamin A-rich foods. (1) Awareness and mobilization have since become an integral component of universal supplementation campaigns and outreach activities. Planning for these efforts is ideally informed by situational analysis of the best communication strategies, messages, and channels.…”

“…Twenty-five years ago, vitamin A capsule or syrup stock-outs were the most widely cited reasons for poor program performance. (1) Supply management has since been a major focus of international assistance. The Canadian International Development Agency (CIDA) remains the primary source of supplies, donated through UNICEF or directly to national programs, including: color-coded soft gel capsules of 200,000 IU and 100,000 IU, available in either halal or non-halal preparations, and vitamin A syrup.…”

Determinants of community-based coverage: periodic vitamin A supplementation. Aceh Study Group.

“…Distribution can be carried out either as a special, single-purpose program or integrated into existing primary health care activities. 8 Presently, over 100 million oral doses of vitamin A are distributed annually, the bulk of which are provided as gelatin capsules by UNICEF. 9 Community and distributor factors influencing capsule coverage are largely unknown.…”