title: Effects on vitamin A deficiency in children of periodic high-dose supplements and of fortified oil promotion in a deficient area of the Philippines.
abstract: Regular semi-annual distribution of high-dose (200,000 IU) vitamin A capsules (VACs) to children 1 - 5 years of age (previously identified as underweight), in Leyte Province, the Philippines, was compared to providing extra VACs to give three-monthly dosing, and to vitamin A-fortified cooking oil (VAFO) promotion (with continued VACs every 6 months). Serum retinol (SR) was measured at baseline and after 12 or 18 months (for VAFO). No sustained increase in SR was determined from the three-month VAC dosing regimen, and the prevalence of vitamin A deficiency (VAD) as assessed by SR (< 20 mcg / dL) remained around 30 % (in line with national survey estimates over the previous 15 years). The major difference found was that 18 months of VAFO (of which 9 months had sustained promotion) was associated with reducing the prevalence of VAD to < 10 %. The effective fortification and lack of effect of semi-annual VAC results are in line with previous studies; testing with dosing of VAC every three months is a new intervention. The results imply that promotion of fortified oil would reduce VAD in these conditions; whether it can replace or needs to be added to semi-annual VAC dosing remains to be determined. A phased changeover to reliance on fortified commodities (including oil) with careful monitoring of VAD trends is indicated.
authors.affiliation: Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans 70112, USA. masonj@tulane.edu
authors.forename: John B
authors.initials: JB
authors.lastname: Mason
authors.forename: Maria A
authors.initials: MA
authors.lastname: Ramirez
authors.forename: Chona M
authors.initials: CM
authors.lastname: Fernandez
authors.forename: Regina
authors.initials: R
authors.lastname: Pedro
authors.forename: Tina
authors.initials: T
authors.lastname: Lloren
authors.forename: Lisa
authors.initials: L
authors.lastname: Saldanha
authors.forename: Megan
authors.initials: M
authors.lastname: Deitchler
authors.forename: T
authors.initials: T
authors.lastname: Eisele
mesh_terms: D002675:Child, Preschool; D000074263:Coconut Oil; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D008297:Male; D010679:Philippines / Q000453:epidemiology; D010938:Plant Oils / Q000008:administration & dosage*; D014801:Vitamin A / Q000008:administration & dosage* / Q000032:analysis / Q000097:blood; D014802:Vitamin A Deficiency / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D010938:Plant Oils; D014801:Vitamin A; D000074263:Coconut Oil