Abstract
Childhood blindness due to corneal ulceration was prevalent among poor Indian children. To tackle this situation, the National Institute of Nutrition (NIN), Hyderabad, India, Vitamin-A (Vit-A) prophylaxis programme was launched nationally in 1970 after field testing. Research of Indian Council for Medical Research (ICMR) documented that prevalence of Vit-A deficiency signs such as Bitot's spot decreased among children, over a period of time. However, this decrease cannot be ascertained is due to mass Vit-A prophylaxis programme. This is because coverage was low and patchy. Improved nutrition status, wider vaccination coverage, increased rate in breast feeding and improvement of healthcare services played a crucial role. Rather many studies revealed that (mass prophylaxis to the child who is having adequate Vit-A level) it may be harmful to certain group of children as a result of acute toxic symptoms. High dose of Vit-A is capable of loss of bone density-hence retarded growth may be observed in susceptible individuals. To tackle this issue food based approach should be promoted (which includes breast feeding) along with timely measles vaccination. The children who have signs of Vit-A deficiency (e.g. night blindness, xeropthalmia, Bitot's spot) or post measles children should receive Vit-A in age specific daily doses for two weeks along with Vit-A rich food, like green leafy vegetables, red palm oil, liver etc. Public spirited citizens, together with scientific community in India, should discourage this “one size fit to all” approach. It will not only avoid the ill effects of high dose of Vit-A but also it will help us optimal utilization of health resources in a resource poor country like India.
Highlights
International public health policy makers recommend mega dose of Vitamin-A (Vit-A) to all children aged between 6–60 months irrespective of nutritional status
Time to phase out the universal Vitamin-A supplementation programme [3]
Vitamin-A capsules have been the major focus of the Vitamin-A deficiency eradication programme in Indonesia
Summary
International public health policy makers recommend mega dose of Vitamin-A (Vit-A) to all children aged between 6–60 months irrespective of nutritional status. According them it is a major public health problem in 1950s–60s. Leading cause of childhood blindness (ocular morbidity) due to corneal ulceration was rampant among poor children To overcome this situation, in India, the National Institute of Nutrition (NIN), pilot tested with mega dose of Vit-A to the vulnerable children so that the problem of keratomalacia may be controlled. Various studies revealed that mass administration (even in healthy children) of mega dose of Vit-A was not needed They considered the possible harmful effects of mega dose Vit-A supplementation. It was opined that it should be phased out [8]
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