Vitamin A supplementation

INTRODUCTION

Vitamin A deficiency (VAD) is a common problem among pre school children. This can lead to high child mortality and morbidity. Globally an estimated 254 million pre-school-aged children are Vit A deficient. 

Vitamin A deficiency has profound effects on the health of children including impaired immunity and iron deficiency anaemia as well as visual impairment and blindness.

All these effects have a negative impact on learning and development of a child.

A micronutrient survey conducted in Kenya in 1999 revealed that 76% and 39% of children below 5 years of age and mothers respectively suffer from vit A deficiency. In order to reduce the deficiency level WHO/UNICEF recommended Vit A supplementation.

Kenya started V.A.S (Vit A supplementation) in 2000 through campaigns and has been delivering twice yearly to children aged 6-59 months through ministry of health; children in ECD (early child development) however are not reached by this strategy.

ECD approaches are being implemented by the ministry of public health and sanitation and ministry of education, ECD department. The main objective of this strategy is to increase VAS coverage for children in ECD centres and this will contribute significantly to millennium development goals 2 & 4, which aim at universal education and reduction of child mortality respectively.

1.1 WHAT IS VIT A ?

Vit A is an essential nutrient required in very small amounts to boast immunity and ensure the proper functioning of the body. 

It is a fat soluble Vit and the body cannot make it, but can store it in the liver for up to 6 months.

1.2 WHAT ARE THE SOURCES OF VIT A.

Natural sources of vit A include:

Animal based sources such as liver, whole milk products, butter, fish, meat and eggs.

Plant based sources: such as oranges, yellow fruits, lemons, yellow vegetables and dark green leafy vegetable which should be consumed with a little oil.

Vit A can also be delivered from:

Vit A Supplements.

Vit A fortified foods especially fortified oil.

1.3 IMPORTANCE OF VIT A IN THE BODY

It helps to prevent and decrease the severity of many infections such as diarrhea and measles, by enhancing the immunity system.

It increases chances of survival for young children by reducing over all mortality by 23%; reducing death from measles by 50%; reducing death from diarrhea by 33%.

It is necessary for growth and development.

It is vital for the proper functioning of the eyes.

It contributes to the foetal development.

Fewer hospital admissions, hence less strain on clinic/out patient and inpatient services.

Improving Vit A status improves resistance to infections and contributes to reduction of child mortality.

It aids iron absorption hence it reduces anaemia.

Vit A is essential for the body and increases the chances of survival for young children.

1.4 CAUSES OF VIT A DEFICIENCY

Low consumption of Vit A rich feeds.

Too little absorption of Vit A from food.

Increased Vit A requirement during phases of rapid growth in young children.

Rapid utilization of Vit A during illness ( particularly measles, diarrhea and fevers), pregnancy and lactation.

1.5 WHAT ARE THE EFFECT OF A LOW VIT A STATUS?

The immune system becomes weak and illnesses are more common and more severe, increasing under 5 death rates.

The eye could be damaged with appearance of lesions and, when severe, it can cause blindness (xerophtalmia)

There is an increase in woman’s risk of dying during pregnancy and the 1st three months after delivery.

1.6 WHO NEEDS VIT A AND WHY? 

Children 0-6 months: to boost the body's immune system and prevent childhood illnesses. The recommended source is breast milk. 

Children 6 months to 59 months: to reduce severity of diarrhea and measles.

For proper growth and developments. In this age the sources are: dietary sources and twice yearly vitamin A supplementation. Of course still breast milk. In this age group Vit A is very important to ensure the proper functioning of the eyes and to prevent night blindness and Bitot’s spot. Lactating mothers: to prevent night blindness and Bitot’s spot. To boost the body’s immune system for mothers. Contribution to increase Vit A in breast milk. For lactating mothers we have: Dietary sources. Vitamin A Supplementation for lactating mothers within 4 weeks of delivery.

1.7 INTERVENTIONS TO REDUCEVIT A DEFICIENCY.

Vitamin A supplementation:

Vitamin A capsules given twice yearly at six months intervals to children 6 to 59 months and post partum mother's within 4 weeks after delivery.

Exclusive breastfeeding for the 1st six months of live and continued breast feeding up to 2 years. Food fortification: Fortification is the process of adding Vit A to foods commonly consumed by vulnerable population. Dietary modification and diversification: parents should combine 2-3 different foods during the meal preparation.

N/B.

Don’t administer Vit A supplement if the child has received Vit A capsule in the last one month.

The side effects from VAS are rare but can include nausea and vomiting which will go away with time.

There are no conditions or illnesses that wound prevent a child from being given Vit A.

Children who come for preventive supplementation and are sick with measles or xerophtalmia should be referred to the health facility for treatment.

Dr Br Giuseppe Gaido

Clinical and nursing officers

Cottolengo Mission Hospital. Chaaria


La luna a Chaaria.... oggi....