BACKGROUND: Vitamin A supplementation is recommended by WHO in emergency situations. OBJECTIVE: To evaluate the impact of Vitamin A supplementation on childhood mortality in an emergency situation. DESIGN: Since this was not a randomised study, we evaluated the impact in different ways; we used the variation in the delay of provision of Vitamin A in a step-wedged design, compared wartime with pre-wartime mortality and examined whether Vitamin A as a free commodity reduced cultural and social-economic inequalities in childhood mortality. SUBJECTS: 5926 children 6 months to 5 years of age, resident in four suburbs in the capital of Guinea-Bissau between October 1, 1998 and March 31, 1999. INTERVENTIONS: From October 1, 1998 until the end of the war in 1999 all children present in the study area were offered Vitamin A at regular three-monthly visits to their homes. RESULTS: Using the variation in the provision of Vitamin A, we found a slight non-significant reduction in mortality for children between 6 months and 5 years of age (mortality ratio (MR) 0.49; 95% CI 0.09-2.70). Comparing with a three-year period before the war, children offered Vitamin A at home during the war had a 12% reduction in mortality (MR 0.88; 0.41-1.87), whereas the overall impact of the war was an 89% increase in mortality (MR 1.89; 1.32-2.71). Vitamin A supplementation was associated with a reduction in cultural and socio-economic inequalities. CONCLUSIONS: Vitamin A supplementation may have a beneficial impact on childhood mortality in an emergency situation.
BACKGROUND:Vitamin A supplementation is recommended by WHO in emergency situations. OBJECTIVE: To evaluate the impact of Vitamin A supplementation on childhood mortality in an emergency situation. DESIGN: Since this was not a randomised study, we evaluated the impact in different ways; we used the variation in the delay of provision of Vitamin A in a step-wedged design, compared wartime with pre-wartime mortality and examined whether Vitamin A as a free commodity reduced cultural and social-economic inequalities in childhood mortality. SUBJECTS: 5926 children 6 months to 5 years of age, resident in four suburbs in the capital of Guinea-Bissau between October 1, 1998 and March 31, 1999. INTERVENTIONS: From October 1, 1998 until the end of the war in 1999 all children present in the study area were offered Vitamin A at regular three-monthly visits to their homes. RESULTS: Using the variation in the provision of Vitamin A, we found a slight non-significant reduction in mortality for children between 6 months and 5 years of age (mortality ratio (MR) 0.49; 95% CI 0.09-2.70). Comparing with a three-year period before the war, children offered Vitamin A at home during the war had a 12% reduction in mortality (MR 0.88; 0.41-1.87), whereas the overall impact of the war was an 89% increase in mortality (MR 1.89; 1.32-2.71). Vitamin A supplementation was associated with a reduction in cultural and socio-economic inequalities. CONCLUSIONS:Vitamin A supplementation may have a beneficial impact on childhood mortality in an emergency situation.
Authors: Thomas Fürst; Andres B Tschannen; Giovanna Raso; Cinthia A Acka; Don de Savigny; Olivier Girardin; Eliézer K N'Goran; Jürg Utzinger Journal: Emerg Themes Epidemiol Date: 2010-08-31
Authors: Shailja Shah; Zahra Ali Padhani; Daina Als; Mariella Munyuzangabo; Michelle F Gaffey; Wardah Ahmed; Fahad J Siddiqui; Sarah Meteke; Mahdis Kamali; Reena P Jain; Amruta Radhakrishnan; Anushka Ataullahjan; Jai K Das; Zulfiqar A Bhutta Journal: BMJ Glob Health Date: 2021-04
Authors: Ane B Fisker; Peter Aaby; Carlito Bale; Ibraima Balde; Sofie Biering-Sørensen; Jane Agergaard; Cesario Martins; Bo M Bibby; Christine S Benn Journal: BMJ Open Date: 2012-01-12 Impact factor: 2.692