Vitamin A supplements: a guide to their use in the treatment and prevention of vitamin A deficiency and xerophthalmia
Provides concise, authoritative advice on the use of high-dose vitamin A supplements for the control of vitamin A deficiency and the emergency treatment of xerophthalmia and other conditions in high-risk groups. Now in its second edition, the guide has been updated and expanded to reflect the latest scientific knowledge, particularly concerning the safety and effectiveness of different dose schedules in different age and population groups. Recommended lines of action also draw on practical experiences gained in the recent international drive to eliminate vitamin A deficiency as a public health problem by the year 2000.
The guide is addressed to programme managers and administrators and aims to answer all practical questions concerning how much vitamin A should be given to different age and population groups, how often, and in what form. Details range from an alert to conditions that should be treated as medical emergencies, through advice on how to calculate procurement requirements, to the simple warning that oil-based preparations should never be injected.
The guide has five sections. The first explains the role of high-dose vitamin A supplements as a proven strategy for controlling xerophthalmia, preventing nutritional blindness and, among deficient populations, reducing the severity and case-fatality rate of certain childhood infections, particularly measles and diarrhoea. Factors influencing the choice of target populations, distribution schemes, and overall programme strategies are also briefly discussed.
Section two presents schedules, for universal and targeted distribution, for the prevention of vitamin A deficiency, xerophthalmia, and nutritional blindness in infants and young children. Questions about safety, side effects, and the potential hazards of overdosing are addressed and clearly answered. Subsequent sections give treatment schedules for xerophthalmia in all age groups and in the special case of pregnant women, and summarize the rationale for supplementation during measles.
Operational issues are discussed in the final and most extensive section, which includes information on the practical and technical advantages of different vitamin A preparations, sources of supplies and their costs, steps to follow in procurement planning, and various options for channelling delivery through existing health care services.
The guide concludes with a list of countries categorized according to the significance of vitamin A deficiency as a public health problem, a summary of the scientific rationale for vitamin A supplementation, and detailed information on the potency retention, at different storage temperatures, of commonly used vitamin A preparations.