Is it time for South Africa to end the routine high-dose vitamin A supplementation programme?

Is it time for South Africa to end the routine high-dose vitamin A supplementation programme? S Afr Med J. 2019 Nov 27;109(12):907-910 Authors: Coutsoudis A, Sanders D, Dhansay MA, Van Stuijvenberg ME, Benn CS Abstract In accordance with World Health Organization guidelines, South Africa (SA) introduced routine periodic high-dose vitamin A supplementation (VAS) in 2002. These guidelines were developed after research in the 1980s and 1990s showed the efficacy of VAS in reducing childhood mortality. However, two recent studies in low- to middle-income countries (2013 and 2014) have shown no effect of high-dose VAS on mortality. Additionally, there is no clear research evidence that 6-monthly doses of vitamin A result in a sustained shift in serum retinol levels or reduce subclinical vitamin A deficiency. These two points should encourage SA to re-examine the validity of these guidelines. A long-term view of what is in the best interests of the majority of the people is needed. The short-term intervention of administering vitamin A capsules not only fails to improve serum retinol levels but may create dependence on a 'technical fix' to address the fundamental problem of poor nutrition, which is ultimately underpinned by poverty. It may also cause harm. Although there are those, some with vested interests, who will argue for continuation of the routine high-dose VAS programmes, SA policymakers and scientists need to evaluate the facts an...
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research