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 Table of Contents  
LETTER TO EDITOR
Year : 2014  |  Volume : 1  |  Issue : 2  |  Page : 29-30

Vitamin-A deficiency: A global cause of public health concern


Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Ammapettai, Kancheepuram, Tamil Nadu, India

Date of Web Publication22-May-2014

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Ammapettai, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2148-7731.132970

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Vitamin-A deficiency: A global cause of public health concern. Sifa Med J 2014;1:29-30

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Vitamin-A deficiency: A global cause of public health concern. Sifa Med J [serial online] 2014 [cited 2019 May 23];1:29-30. Available from: http://www.imjsu.org/text.asp?2014/1/2/29/132970

Sir,

Vitamin-A deficiency (VAD) is a significant public health problem, especially in developing countries and in low-resource settings. Globally, night blindness affects 5.2 million pre-school age children and 9.8 million pregnant women, which corresponds to 0.9% and 7.8% of the population at risk of VAD, respectively. [1] For certifying VAD as a public health problem in a region, the prevalence of xerophthalmia has to be >1% among pre-school children and 5% or higher among pregnant women. [2]

The main etiology in the development of VAD is prolonged ingestion of a diet deficient in vitamin-A, resulting in failure to maintain physiologic requirements (infancy/childhood/pregnancy/lactation) and exhaustion of body stores. [1] Other risk factors such as unnecessary dietary restrictions imposed by the parents; [3] food fads; [3] xerophthalmia in mothers; [3] association with diarrheal diseases; [1],[4] poor socio-economic status; [1],[3] roundworm infection, measles, respiratory infection, malnutrition, alcohol-induced malnutrition; [4] young age, male gender, type of agriculture production, lack of comprehensive governmental policy; [5] and the availability of vitamin-A in adequate quantities; [6] have been also attributed in the causation of VAD.

Presence of VAD in a population is diagnosed with either biochemical (serum retinol) or clinical (eye signs) parameters. [1] Deficiency of vitamin-A can lead to conditions like xerophthalmia, anemia, increased susceptibility to infections, growth retardation and risk of death. [1],[7] Xerophthalmia has been regarded as the leading cause of preventable childhood blindness across the world. [7] Many of the studies have been done across the globe for estimation of prevalence of VAD among different vulnerable sections of population. [3],[8]

The actual reach of healthcare services to the population at-risk is far from optimum in most of the geographical regions. [4],[6] In a study to evaluate the knowledge of trained outreach workers it was revealed that almost 67.1% of workers were not aware of the corrective measures to prevent VAD. [9] Three pronged community interventions have been advocated to reduce prevalence of VAD in high-risk populations. Firstly, augmenting the intake of vitamin-A rich foods through dietary diversification/nutrition education to modify eating practices/encouraging home gardening where vitamin-A rich foods are not locally available or are expensive. [1] Secondly, promotion of fortification of staple foods such as fats, oils, margarine and cereal products with vitamin-A. [1] Third and the most widely practiced approach is to periodically administer vitamin-A to pre-school children (<5 years) with 200,000 IU and half of this dose to infants (6-11 months). [8] It is an alarming fact that xerophthalmia has not been controlled despite the existence of different intervention programs in multiple countries. [2],[8],[9] The need of the hour is to focus on other contributing factors such as promoting female education; [8] regular deworming in children; [3] facilitating social marketing activities; [10] educating parents about VAD and its prevention; [1],[3] extending supplementary dosage for pregnant women/lactating mothers; [3] involvement of community members in outreach immunization sessions; [9] regular training sessions for the paramedical health staff; [9] and health talk for the general population to motivate them to consume vitamin-A rich diet; [5],[6] to keep the problem of VAD under check.

To conclude, strong political commitment translated into policy choices and actions and backed by adequate knowledge, capacity, international cooperation and resources, can ensure a large-scale impact on the problem of child labor in the near future.

 
  References Top

1.World Health Organization. Global prevalence of vitamin A deficiency in populations at risk 1995-2005. Who Global Database on Vitamin-A Deficiency. Geneva: WHO Press; 2009.  Back to cited text no. 1
    
2.Christian P. Recommendations for indicators: Night blindness during pregnancy-A simple tool to assess vitamin A deficiency in a population. J Nutr 2002;132 9 Suppl:2884S-8.  Back to cited text no. 2
    
3.Semba RD, de Pee S, Panagides D, Poly O, Bloem MW. Risk factors for xerophthalmia among mothers and their children and for mother-child pairs with xerophthalmia in Cambodia. Arch Ophthalmol 2004;122:517-23.  Back to cited text no. 3
    
4.Pal R, Sagar V. Antecedent risk factors of xerophthalmia among Indian rural preschool children. Eye Contact Lens 2008;34:106-8.  Back to cited text no. 4
    
5.Schémann JF, Malvy D, Zefack G, Traoré L, Sacko D, Sanoussi B, et al. Mapping xerophthalmia in Mali: Results of a national survey on regional distribution and related risk factors. J Am Coll Nutr 2007;26:630-8.  Back to cited text no. 5
    
6.Sherwin JC, Reacher MH, Dean WH, Ngondi J. Epidemiology of vitamin A deficiency and xerophthalmia in at-risk populations. Trans R Soc Trop Med Hyg 2012;106:205-14.  Back to cited text no. 6
    
7.World Health Organization. 10 facts about blindness and visual impairment, 2013. Available from: http://www.who.int/features/factfiles/blindness/blindness_facts/en/index6.html. [Last accessed on 2013 Oct 22].  Back to cited text no. 7
    
8.Dole K, Gilbert C, Deshpande M, Khandekar R. Prevalence and determinants of xerophthalmia in preschool children in urban slums, Pune, India-A preliminary assessment. Ophthalmic Epidemiol 2009;16:8-14.  Back to cited text no. 8
    
9.Shrivastava SR, Shrivastava PS. Evaluation of trained accredited social health activist (ASHA) workers regarding their knowledge, attitude and practices about child health. Rural Remote Health 2012;12:2099.  Back to cited text no. 9
    
10.Dary O, Mora JO, International Vitamin A Consultative Group. Food fortification to reduce vitamin A deficiency: International vitamin A consultative group recommendations. J Nutr 2002;132:2927S-33.  Back to cited text no. 10
    




 

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