Vitamin A deficiency (VAD) remains a significant a cause of preventable childhood blindness and increased risk of mortality among children under five years of age, although improvements have been made due to VAD programmes and increase coverage with measles immunization.
Despite this, VAD is a major public health problem in the developing world affecting 190 million children under five particularly in Africa and South East Asia with India contributing to 85% of cases in South East Asia (WHO, 2009). Biochemical VAD is of public health significance in 122 countries and clinical VAD is of concern in 45 countries (WHO, 2009).
Treatment and successes
Vitamin A supplementation completely “stops”/prevents childhood blindness from vitamin A deficiency.
Just 2 doses of vitamin A given annually to all children 6-59 months of age prevents their developing vitamin A deficiency blindness. Because vitamin A deficiency can have a range of consequences, including an increased risk of child mortality, the term now used is “vitamin A deficiency disorders” (VADD). The reason why there are global programmes for control of vitamin A deficiency in children is because it also significantly increases under 5 mortality rates in countries where it is a public health problem.
Trends and challenges
Significant progress has been seen globally with an overall rise in VAS coverage among children under 5 years of age with one dose from 50% to 66% (UNICEF, 2012).
The full child survival benefits of VAS need to be realized especially in countries with high under 5 mortality rates (i.e. more than 50 per 1000 live births) U5MR. Adding VAS to child health and immunization days has contributed to increased coverage using a proven, innovative delivery mechanism. Further effort is necessary to accelerate the gains achieved. Advocacy is required to sustain efforts in VAD prevention and control through poverty reduction strategies.
Imdad, A., Herzer, K., Mayo-Wilson, E., Yakoob, M. Y., Bhutta, Z. A. Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age (Review), Cochrane Library, Issue 1, 2011. Internet http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008524.pub2/pdf (Accessed 01 September 2011)
UNICEF (2007) Vitamin A Supplementation: A Decade of Progress. Available from: http://www.unicef.org/publications/files/Vitamin_A_Supplementation.pdf (Accessed 09 May 2011)
UNICEF (2012). The State of the World’s Children: Children in an urban world. Internet http://www.unicef.org/sowc2012/statistics.php (Accessed 07 April 2012)WHO (2009) Global prevalence of vitamin A deficiency in populations at risk 1995–2005: WHO global database on vitamin A deficiency. Available from http://whqlibdoc.who.int/publications/2009/9789241598019_eng.pdf (Accessed 09 May 2011)
Do vitamin A deficiency and undernutrition still matter? Comm Eye Health Vol. 26 No. 84 2013. Published online 20 December, 2013.