title: Prevalence of vitamin A deficiency in South Asia: causes, outcomes, and possible remedies.
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.
authors.affiliation: Department of Food Science &Technology, Bahauddin Zakariya University, Multan, Pakistan. saeedbzu@yahoo.com
authors.forename: Saeed
authors.initials: S
authors.lastname: Akhtar
authors.affiliation: Department of Food Technology, PMAS-Arid Agriculture University, Rawalpindi 46300, Pakistan.
authors.forename: Anwaar
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan.
authors.forename: Muhammad Atif
authors.initials: MA
authors.lastname: Randhawa
authors.affiliation: Department of Biochemistry & Molecular Biology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
authors.forename: Sunethra
authors.initials: S
authors.lastname: Atukorala
authors.affiliation: Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Tarnaka-Hyderabad 500 007, India.
authors.forename: Nimmathota
authors.initials: N
authors.lastname: Arlappa
authors.affiliation: Department of Food Science &Technology, Bahauddin Zakariya University, Multan, Pakistan.
authors.forename: Tariq
authors.initials: T
authors.lastname: Ismail
authors.affiliation: Department of Agriculture and Food Technology, Karakoram International University, Gilgit-Baltistan, Pakistan.
authors.forename: Zulfiqar
authors.initials: Z
authors.lastname: Ali
mesh_terms: D000328:Adult; D001211:Asia, Western / Q000453:epidemiology; D015984:Causality; D002648:Child; D015897:Comorbidity; D003906:Developing Countries / Q000706:statistics & numerical data; D004032:Diet / Q000379:methods*; D019587:Dietary Supplements; D005260:Female; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D009755:Night Blindness / Q000178:diet therapy / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D014801:Vitamin A / Q000627:therapeutic use*; D014802:Vitamin A Deficiency / Q000178:diet therapy* / Q000453:epidemiology*; D014815:Vitamins / Q000627:therapeutic use*; D014985:Xerophthalmia / Q000178:diet therapy / Q000453:epidemiology
chemical_list: D014815:Vitamins; D014801:Vitamin A