Vitamin A supplements for preventing illness in children aged under 5: Mathematical and systematic approach at flooding disaster in Samarinda

Abstract

Background: Heavy rains poured for several hours on sunday morning, causing the water level to rise at Benanga dam at the upstream of Karang Mumus river, the confluence of the Mahakam river. The Samarinda administration has applied an emergency protocol for fourteen days to assist 10,300 people affected by the flooding. Health City Office decided to distribute vitamin A to children under 5, as prevention strategy to avoid illness. Vitamin A refers to a subclass of retinoic acids long understood to help regulate immune function and to reduce morbidity of infectious diseases. Vitamin A is required for normal functioning of the visual system, maintenance of cell function for growth, epithelial integrity, production of red blood cells, immunity, and reproduction. Methods and materials: We evaluated the effect of prophylactic synthetic oral vitamin A supplementation compared with no treatment. We planned to conduct three subgroup analyses:1.Location: by flood affected area and buffer zone2.Age: 6–12 months v 1–5 years3.Sex: boys v girls. 1.684 children under 5 in the flood affected area, were given vitamin A, while children under 5 in the buffer area maintained with no treatment. The health status of these children were monitored for 3 months and reported directly to Health City Office Surveillance Department. Results: The morbidity of children under 5, in the buffer area were higher than in the flood affected area by 27%. 81% of cases of children under 5, in the buffer area within 3 months were Upper Respiratory Tract Infection, 12% were unspecified diarrhea. Only 27 children of 1.684 Children given Vitamin A were illness. No side affect or hypervitaminosis of vitamin A reported. Conclusion: Vitamin A supplementation is associated with reductions in illness problems in a range of settings compared to no treatment area in the buffer zone. Health Surveillance is maintained for approximately 3 months. However, there is a need for further studies comparing different doses and delivery mechanisms (for example, fortification). Until other sources are available, vitamin A supplements should be given to all children at risk of disaster, particularly where health access is limited.