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Safety and Mortality Benefits of Delivering Vitamin A Supplementation at 6 Months of Age in Sub-Saharan Africa
| Content Provider | SAGE Publishing |
|---|---|
| Author | Kupka, Roland Nielsen, Jennifer Dhillon, Christina Nyhus Blankenship, Jessica Haskell, Marjorie J. Baker, Shawn K. Brown, Kenneth H. |
| Copyright Year | 2016 |
| Abstract | Vitamin A supplementation (VAS) among children 6 to 59 months of age reduces vitamin A deficiency (VAD)-related mortality. Child health days (CHDs) only reach an estimated 16.7% of children at exactly 6 months, leaving uncovered children at risk of VAD-related mortality; similarly, VAS provided at 9 months of age with measles-containing vaccine leaves infants unprotected for 3 months.Objective:Using data from sub-Saharan Africa, we estimated the mortality benefits and safety of providing VAS at age 6 months, compared to delivery through CHDs and at 9 months.Methods:We modeled VAS-preventable mortality benefits at 6 months as a function of published VAS effect sizes, intervention coverage, and proportion of infant deaths occurring between 6 and 11 months. To evaluate safety, we modeled the effect of different VAS coverage scenarios on maximum hepatic vitamin A concentrations (HVACs).Results:VAS linked to a 6-month visit could reduce infant mortality by an additional 1.95 (95% confidence interval [CI]: 1.38-2.52) and 1.63 (95% CI: 1.15-2.11) percentage points compared to VAS through CHDs and at 9 months, respectively. The HVAC models indicate that VAS at 6 months is safe even in the presence of a second VAS dose 1 month later and other food-based vitamin A control strategies.Conclusion:Advancing the first VAS dose to 6 months should be considered in settings where VAS is currently given first at 9 months. A 6-month VAS dose should also be considered in settings where VAS is delivered through CHDs. VAS delivery at 6 months could also serve as a platform to deliver other high-impact interventions. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/0379572116646280?download=true |
| Starting Page | 375 |
| Ending Page | 386 |
| Page Count | 12 |
| ISSN | 03795721 |
| Issue Number | 3 |
| Volume Number | 37 |
| Journal | Food and Nutrition Bulletin (FNB) |
| e-ISSN | 15648265 |
| DOI | 10.1177/0379572116646280 |
| Language | English |
| Publisher | Sage Publications CA |
| Publisher Date | 2016-05-05 |
| Publisher Place | Los Angeles |
| Access Restriction | Open |
| Rights Holder | © The Author(s) 2016 |
| Subject Keyword | deficiency Africa South of the Sahara vitamin A supplementation immunization |
| Content Type | Text |
| Resource Type | Article |
| Subject | Geography, Planning and Development Nutrition and Dietetics Food Science |
