Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys

Stevens, Gretchen A; Bennett, James L.; Hennocq, Quentin; Lu, Yuan; De-Regil, Luz María; Rogers, Lisa M.; Danaei, Goodarz; Li, Guangquan; White, Richard A.; Flaxman, Seth; Oehrle, Sean-Patrick; Finucane, Mariel M.; Guerrero, Ramiro; Bhutta, Zulfiqar A; Then-Paulino, Amarilis; Fawzi, Wafaie W.; Black, Robert E.; Ezzati, Majid

doi:10.1016/s2214-109x(15)00039-x

Cited by 469 publications

(396 citation statements)

References 35 publications

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“…More recently, WHO has been using multiple indicators to evaluate whether VAD is expected to be a problem in a country, including life expectancy at birth, under-five-mortality rates, gross domestic product, malnutrition rates, measles immunisation rates and regional indicators (World Health Organization, 2009). Based on these figures, WHO estimates that VAD affects a large proportion of children in South-East Asia and Africa (44-50%), estimates which are also supported by recent models based on biochemical data (44-48%) (Stevens, et al, 2015). While VAD is associated with higher mortality (Humphrey, et al, 1992), there are examples where distribution of HDVAC does not lower mortality.…”

Section: Blanket High Dose Vitamin a Supplementation Policymentioning

confidence: 86%

High dose vitamin A capsules – Rusty bullets?

Fisker

Greiner

2017

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SummaryHigh-dose vitamin A capsules (HDVAC) are distributed to preschool children in low-income countries on the assumption that they reduce mortality and treat vitamin A deficiency. As for other so-called magic bullet approaches, donors and policy makers consider their large-scale distribution highly cost-effective. Consequently, other ways to improve vitamin A status have received less attention; both donors and governments assume HDVAC are doing most of what needs to be done. Yet, the only evidence for an effect on mortality comes from 25-year-old studies and this effect no longer appears to be substantial. Surprisingly, impact evaluations have been absent. The only study that might be considered an effectiveness or impact evaluation found HDVAC had no effect in northern India. It is not widely appreciated that the impact of HDVAC on vitamin A status is limited, temporary and not cumulative over time. Nor can it be given to women except immediately after giving birth, and thus it is an inappropriate intervention for tackling vitamin A deficiency. To ensure that we use limited resources wisely, we need to identity and scale up strategies which combat vitamin A deficiency and reduce mortality.

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Section: Blanket High Dose Vitamin a Supplementation Policymentioning

confidence: 86%

High dose vitamin A capsules – Rusty bullets?

Fisker

Greiner

2017

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“…From 1991 to 2013, VAD decreased significantly in Oceania, Southeast and East Asia, Latin America, and Caribbean, but not in South Asia and Sub-Saharan Africa, places where the deficiency still prevails [3]. Brazil does not have official data yet indicating a decrease in VAD, and VAD has been considered a public health problem in the North and Northeast regions, and in some parts of the Midwest and Southeast regions, affecting mainly preschoolers, pregnant women, and puerperal women [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Vitamin A deficiency and factors associated with retinol levels in public school students

et al. 2017

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A B S T R A C T ObjectiveTo estimate the prevalence of vitamin A deficiency and determine the socioeconomic and demographic factors associated with serum retinol levels in public school students. MethodsThis cross-sectional study included 245 students from the urban and rural areas of the city of Teresina, Piauí, Brazil. Socioeconomic data were collected using a form. Serum retinol level was determined by high-performance liquid chromatography and classified according to the cut-off points provided by the World Health Organization. All statistical tests had a significance level of 5%. ResultsThe prevalence of vitamin A deficiency (retinol level <0.70μmol/L) was 9.8% (95%CI=7.9-10.0). The prevalences of low and acceptable retinol levels (<1.05mmol/L) were higher in students aged 12-14 years living in households Revista de NutriçãoRev. Nutri., Campinas, 30(5):605-614, set./out

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“…It affects about 190 million of those children, and estimated 6.9 million die annually due to VAD by the age of five [2]. With serum retinol lower than 0.7 μML -1 which defines VAD, the estimated prevalence of VAD was 29% in 2013 among children aged 6 to 59 months, with the highest rates in Sub-Saharan African countries ranging from 25% to 75%, and South Asian 13% to 79% [3]. Vitamin A is required for normal functioning of the visual system, maintenance of cell function for growth, epithelial integrity, immunity, and reproduction.…”

Section: Introductionmentioning

confidence: 99%

Transgenic Pro-Vitamin A Biofortified Crops for Improving Vitamin A Deficiency and Their Challenges

Lee¹

2017

TOASJ

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Vitamin A Deficiency (VAD) has been a public health problem among children in developing countries. To alleviate VAD, Vitamin A Supplementation (VAS), food fortification, biofortification and nutrition education have been implemented in various degrees of success with their own merits and limits. While VAS is the most widely utilized intervention in developing countries to ease the burden of VAD, some have raised questions on VAS' effectiveness. Biofortification, often touted as an effective alternative to VAS, has received significant attention. Among the available biofortification methods, adopting transgenic technology has not only facilitated rapid progress in science for enhanced pro-Vitamin A (pVA) levels in target crops, but drawn considerable skepticism in politics for safety issues. Additionally, VAD-afflicted target regions of transgenic pVA crops widely vary in their national stance on Genetically Modified (GM) products, which further complicates crop development and release. This paper briefly reviews VAS and its controversy which partly demanded shifts to food-based VAD interventions, and updates the current status of transgenic pVA crops. Also, this paper presents a framework to provide potential influencers for transgenic pVA crop development under politically challenging climates with GM products. The framework could be applicable to other transgenic micronutrient biofortification.

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Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys

Abstract: Bill & Melinda Gates Foundation, Grand Challenges Canada, UK Medical Research Council.

Cited by 469 publications

References 35 publications

High dose vitamin A capsules – Rusty bullets?

High dose vitamin A capsules – Rusty bullets?

Vitamin A deficiency and factors associated with retinol levels in public school students

Transgenic Pro-Vitamin A Biofortified Crops for Improving Vitamin A Deficiency and Their Challenges

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