title: Experience of integrating vitamin A supplementation into polio campaigns in the African Region.
abstract: Vitamin A deficiency is a public health problem that affects children across the WHO African Region. Countries have integrated vitamin A supplementation in different child health interventions, most notably with polio campaigns. The integration of vitamin A in polio campaigns was documented as a best practice in Angola, Chad, Cote d'Ivoire, Tanzania, and Togo. There are potential risks to vitamin A supplementation associated with the polio endgame and certification in the African Region.
  
  
  
  We reviewed the findings from the documentation of best practices assessment that was conducted by the WHO Regional Office for Africa in 2014 and 2015 in the five countries that noted integration of vitamin A with polio as a best practice. In addition, we reviewed the coverage rates for oral poliovirus vaccine and vitamin A supplementation in Angola, Chad, Cote d'Ivoire, Tanzania, and Togo in 2014 and 2015.
  
  
  
  Vitamin A deficiency in 2004 ranged from 35% in Togo to as high as 55% in Angola. All five countries integrated vitamin A supplementation in at least one campaign in 2013-2014 and all achieved over 80% coverage for vitamin A supplementation when it was integrated with polio.
  
  
  
  Given the progress of the polio program, and decreasing campaigns, there is a risk that fewer children will be reached each year with vitamin A supplementation. We recommend that for countries strengthen the integration of vitamin A supplementation with routine immunization services.
authors.affiliation: Center for Disease Prevention and Control, USA. Electronic address: uvz0@cdc.gov.
authors.forename: Elizabeth Tangel
authors.initials: ET
authors.lastname: Chehab
authors.affiliation: World Health Organization, Regional Office for Africa, Brazzaville, Congo.
authors.forename: Blanche-Philomene Melanga
authors.initials: BM
authors.lastname: Anya
authors.affiliation: World Health Organization, Regional Office for Africa, Brazzaville, Congo.
authors.forename: Adelheid Werimo
authors.initials: AW
authors.lastname: Onyango
authors.affiliation: World Health Organization, Regional Office for Africa, Brazzaville, Congo.
authors.forename: Mable Carole
authors.initials: MC
authors.lastname: Tevi-Benissan
authors.affiliation: World Health Organization, Regional Office for Africa, Brazzaville, Congo.
authors.forename: Joseph
authors.initials: J
authors.lastname: Okeibunor
authors.affiliation: World Health Organization, Regional Office for Africa, Brazzaville, Congo.
authors.forename: Pascal
authors.initials: P
authors.lastname: Mkanda
authors.affiliation: World Health Organization, Regional Office for Africa, Brazzaville, Congo.
authors.forename: Richard
authors.initials: R
authors.lastname: Mihigo
mesh_terms: D000349:Africa / Q000453:epidemiology; D002648:Child; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D011051:Poliomyelitis / Q000517:prevention & control; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage; D017410:Practice Guidelines as Topic; D013636:Tanzania / Q000453:epidemiology; D014037:Togo / Q000453:epidemiology; D014801:Vitamin A / Q000008:administration & dosage*; D014802:Vitamin A Deficiency / Q000453:epidemiology / Q000517:prevention & control*; D014944:World Health Organization
chemical_list: D011055:Poliovirus Vaccine, Oral; D014801:Vitamin A
keywords: Integration of health services; Polio; Supplementary immunization activities; Vitamin A