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Indian Journal of Community Medicine

Letters to the Editor

Author(s): Dr. P.L. Gattani

Vol. 25, No. 3 (2000-07 - 2000-09)

Sir,

Herewith I am enclosing my views about vit. A supplementation and its linking with pulse polio with its references I have gone through.

Comments:

1. Though there is decline in clinical vitamin A deficiency in underfive children in the country, it is estimated that still 5,65,000 children suffered from clinical VAD in 1998. (World Health Report 1999). Subclinical VAD is about 100 times more than that of clinical VAD (World Health Report 1998).

2. The effect of VAD on mortality is pronounced for diarrhoeal diseases and is demonstrable for measles (WHR 98). Even increased morbidity and mortality occur at levels of VAD less severe and chronic than required for night blindness and xerophthalmia. Improving the vit A status of deficient children is an important component of comprehensive child survival strategy (Abstract from the world summit for children held at Rockfeller study centre in Bellagio, Italy from Feb 3-7, 1992).

3. Diets of poor income groups in India are deficient in vitamin A (Nutritive value of Indian foods, NIN, 1996). In a study carried out in rural India in the age group 1-15 years, the adequacy of dietary intake of vitamin A ranged from 8-12% as compared to recommended dietary allowances (Khamgaonkar et al. Vitamin A intake and vitamin A deficiency in rural children. Indian Paediatrics 1990, 443-46).

4. Vitamin A supplementation coverage in India in the age group 6-59 months was just 25% for the year 1998. (State of World's Children 2000, UNICEF). In view of the above findings vitamin A supplementation is to be continued till household food security is ensured by uplifting the socio-economic status of the community which is a long term measure.

Also FIRST PULSE POLIO DOSE may be linked with vitamin A supplementation as routine vitamin A coverage is just 25%. But linking of all PPI days should be avoided due to the risk of hypervitaminosis and its toxicity.

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