Demographic and Health-Related Risk Factors of Subclinical Vitamin A Deficiency in Ethiopia

By Demissie, Tsegaye; Ali, Ahmed et al. | Journal of Health Population and Nutrition, October 2009 | Go to article overview
Save to active project

Demographic and Health-Related Risk Factors of Subclinical Vitamin A Deficiency in Ethiopia


Demissie, Tsegaye, Ali, Ahmed, Mekonnen, Yared, Haider, Jemal, Umeta, Melaku, Journal of Health Population and Nutrition


INTRODUCTION

The far-reaching health consequence of vitamin A deficiency is well-substantiated by numerous well-designed scientific studies (1,2). Meta-analysis of a number of trials has clearly demonstrated that as much as 23% reduction in mortality of children could be achieved by improving vitamin A status (3). Several studies have established that vitamin A deficiency is a major public-health problem in Ethiopia (4-10). Except in the southern region where studies have consistently shown low levels of vitamin A deficiency (4,10), the problem has continued to constitute a major public-health concern in other regions. In some regions, close to 8% prevalence rate of Bitot's spot (clinical vitamin A deficiency) was reported, perhaps the highest rate ever recorded in the world (6). The fifth nutrition situation report of the Standing Committee on Nutrition of the United Nations indicates that the prevalence of xerophthalmia in Ethiopia is the highest in the world (11).

Cognizant of the wide-scale prevalence and enormous health impacts, interventions were initiated as early as in 1960 in Ethiopia. During 1969-1973, a pilot intervention study in two towns--one with nutrition education and the other with vitamin A capsule distribution--emphasized the value of these interventions, and following this, disease-targeted vitamin A supplementation, along with nutrition education, was initiated. The nationwide vitamin A supplementation began in 1995 as a component of Expanded Programme on Immunization (EPI), and starting from 1997, vitamin A supplementation was effected through campaigns either integrated with the National Immunization Days or as a stand-alone activity. Initially, the coverage was good but later the coverage dropped substantially as a result of deaths occurring during the supplementation. While squeezing the contents of the capsule during oral dosing, in some rare instances, the entire capsules slipped into the mouth of children and choked them by sticking to esophagus and blocking air passage. At the time of this survey, an enhanced outreach strategy, incorporating deworming and other health interventions, along with vitamin A supplementation, was being implemented in three regions.

The primary cause of vitamin A deficiency is inadequate dietary consumption of vitamin A and/ or suboptimal use of the nutrient in the body. A number of secondary factors contribute to insufficient dietary intake of vitamin A. Inadequate production of vitamin A-rich foods, lack of income to purchase, unavailability of vitamin A-rich foods in markets, a large family size, high maternal parity levels, low level of maternal education, low levels of awareness of the importance of vitamin A, and illness are some secondary factors that are presumed to contribute to inadequate consumption of vitamin A in developing countries.

As the risk factors and determinants of vitamin A are context-specific (socioeconomic, cultural, environmental, etc.), variations in factors contributing to vitamin A deficiency exist among countries, regions, and localities, underlining the need to assess country/region/area-specific risk factors. Knowledge on such specific risk factors enables implementers and policy-makers to design and implement effective interventions. Unfortunately, studies relating to country and region or area-specific causes of vitamin A in Ethiopia are scarce, and hence, substantive information regarding factors contributing to vitamin A deficiency is lacking. The aim of this study was to partially fill the information gap on causes of vitamin A deficiency by providing information on some demographic and health-related risk factors.

MATERIALS AND METHODS

Survey design and sampling

Multi-stage, cluster-sampling approach and cross-sectional design were employed in the study. Nine of the 11 regional administrative states that constitute the Federal Government of Ethiopia were included in the survey (two regions were excluded due to security reasons).

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Demographic and Health-Related Risk Factors of Subclinical Vitamin A Deficiency in Ethiopia
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?