National Vitamin A Prophylaxis Programme: need for change in current age strategy

Area of Science:

• Public Health
• Nutritional Science
• Pediatrics

Background:

• The Child Survival and Safe Motherhood Programme recommends vitamin A prophylaxis up to three years of age.
• This contrasts with previous practices of extending supplementation up to six years of age.
• The current strategy assumes reduced risk of severe vitamin A deficiency manifestations after three years.

Purpose of the Study:

• To investigate the prevalence of vitamin A deficiency in children under six years old in urban slums of Nagpur, India.
• To assess both clinical and subclinical vitamin A deficiency in the post-CSSM (Child Survival and Safe Motherhood) program era.
• To evaluate the effectiveness of the current age strategy for vitamin A supplementation.

Main Methods:

• A cross-sectional study involving 1094 children in urban slums.
• Clinical assessment of xerophthalmia (vitamin A deficiency eye disease).
• Subclinical vitamin A deficiency assessment using conjunctival impression cytology, following WHO guidelines.

Main Results:

• The overall prevalence of xerophthalmia was 8.7%, with only milder manifestations observed.
• A significantly higher prevalence of xerophthalmia was found in children older than three years.
• Higher prevalence of subclinical vitamin A deficiency was noted in the over-three-years age group, though not statistically significant.

Conclusions:

• Current age strategies for vitamin A supplementation (up to 3 years) may be insufficient.
• Higher prevalence of both clinical and subclinical vitamin A deficiency in children over three warrants a review of supplementation guidelines.
• Further research and policy review are needed to ensure adequate vitamin A status in all young children.