Vitamin A deficiency and childhood morbidity and mortality : scientific background and implications for child survival

An initial literature review covers the relationship of Vitamin A deficiency to child mortality, the immune system, respiratory infection, diarrheal disease, measles, and other morbidities; a model explaining the relationship between Vitamin A deficiency and infection is included. Various methods of identifying Vitamin A deficiency are then discussed, including clinical signs and symptoms, biochemical assessments, cytology (the ICEPO and Amedee-Manesme techniques, and urinalysis), and dietary assessment. Problems involved in estimating the prevalence of Vitamin A deficiency are discussed, such as inconsistent case definitions; the rarity, clustering, and seasonality of the condition; and the expertise and resources required for determining Vitamin A status. A review of Vitamin A interventions and programs concludes by comparing the effectiveness and sustainability of capsule distribution, MSG fortification, and dietary education. Results underscore the interim nature of capsule distribution, the difficulty of reaching high-risk children, and the need for nutrition education and social marketing. The report concludes with several recommendations for continued Vitamin A research and programs. Includes eight-page bibliography.