Abstract
Vitamin A deficiency (VAD) has been recognized as a public-health issue in developing countries. Economic constraints, sociocultural limitations, insufficient dietary intake, and poor absorption leading to depleted vitamin A stores in the body have been regarded as potential determinants of the prevalence of VAD in South Asian developing countries. VAD is exacerbated by lack of education, poor sanitation, absence of new legislation and enforcement of existing food laws, and week monitoring and surveillance system. Several recent estimates confirmed higher morbidly and mortality rate among children and pregnant and non-pregnant women of childbearing age. Xerophthalmia is the leading cause of preventable childhood blindness with its earliest manifestations as night blindness and Bitot's spots, followed by blinding keratomalacia, all of which are the ocular manifestations of VAD. Children need additional vitamin A because they do not consume enough in their normal diet. There are three general ways for improving vitamin A status: supplementation, fortification, and dietary diversification. These approaches have not solved the problem in South Asian countries to the desired extent because of poor governmental support and supervision of vitamin A supplementation twice a year. An extensive review of the extant literature was carried out, and the data under various sections were identified by using a computerized bibliographic search via PubMed, Web of Science, and Google Scholar. All abstracts and full-text articles were examined, and the most relevant articles were selected for screening and inclusion in this review. Conclusively, high prevalence of VAD in South Asian developing countries leads to increased morbidity and mortality among infants, children, and pregnant women. Therefore, stem efforts are needed to address this issue of public-health significance at local and international level in lower- and middle-income countries of South Asia.
Highlights
South Asia constitutes one-fifth of the world’s population, and many of the nations have been severely affected by malnutrition
Educating mothers on Vitamin A deficiency (VAD) in low-income South Asian developing societies holds a potential to reduce the gravity of VAD in these regions, e.g. children aged less than five years did not receive vitamin A supplementation owing to low maternal education in Bangladesh [72]
A substantial number of children and pregnant/lactating women are the victims of vitamin A deficiency in South Asian developing countries due to poverty and allied socioeconomic constraints
Summary
South Asia constitutes one-fifth of the world’s population, and many of the nations have been severely affected by malnutrition. India has the highest prevalence of clinical and subclinical VAD among South Asian countries; 62% of preschool children were reported to be deficient in vitamin A. Subclinical VAD still remains a public-health problem in Sri Lanka, despite the availability of a supplementation programme for children and pregnant and lactating women.
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