Assessment of the short-term effectiveness of the Vitamin A supplementation program in Kostanai County, Northern Kazakhstan

Grjibovski, Andrej

Assessment of the short-term effectiveness of the Vitamin A supplementation program in Kostanai County, Northern Kazakhstan

Tuesday, 19 August 2014

Exhibit hall (Dena'ina Center)

Feruza Ospanova, MD , Kazakh Academy of Nutrition, Almaty, Kazakhstan

Arailym Beisbekova, MD , Kazakh Academy of Nutrition, Almaty, Kazakhstan

Zarina Kenzhekova, MD , Kazakh Academy of Nutrition, Almaty, Kazakhstan

Altyn Sarsembaeva, MD , Kazakh Academy of Nutrition, Almaty, Kazakhstan

Bayan Bozhbanbayeva, MD , Kazakh Academy of Nutrition, Almaty, Kazakhstan

Samal Zhaishybayeva, MD , Kazakh National Medical University, Almaty, Kazakhstan

Fariza Bimurzaeva, MD , Kazakh National Medical University, Almaty, Kazakhstan

Shamil Tazhibayev , Kazakh Academy of Nutrition, Almaty, Kazakhstan

Toregeldi Sharmanov, PhD , Kazakh Academy of Nutrition, Almaty, Kazakhstan

Andrej M Grjibovski, PhD , Northern State Medical University, Arkhangelsk, Russia

INTRODUCTION: The WHO recommends high-dose vitamin A supplementation (VAS) for children above six months of age in low-income countries. A meta-analysis of the previous trials VAS in developing countries has concluded that supplementation could generally reduce childhood mortality by about 20–30%. Kazakhstan is a developing country in Central Asia with among the highest under 5 mortality in the European WHO region. We studied short-term effectiveness of VAS in Kostanai county, North Kazakhstan.

METHODS: A cohort of 250 children aged 6-59 months was followed up for 9 months. Serum Vitamin A concentration was assessed at the beginning and at the end of the follow up period. The serum vitamin A concentration was measured by use of high-performance liquid chromatography (HPLC) at the calibrated laboratory of the Kazakh Academy of Nutrition. Proportions of children with normal serum levels of Vitamin A before and after VAS were compared using McNemar tests.

RESULTS: Proportion of children with normal serum levels of vitamin A after VAS increased from 33.2% (95% CI: 27.4-29.4) to 98.8% (95% CI: 96.5-99.8), p<0.001. The mean Vitamin A concentration after VAS was 56.54µg/dL (95% CI: 54.35-58.73).

CONCLUSIONS: The results suggest that the programme was effective in terms of increasing serum levels of Vitamin A among children in the studied age-group. Long term effects need longer observations. Coverage estimation for vitamin A supplementation program is one of most powerful indicators of program success. There is a need for representative population-based coverage surveys to complement and validate National vitamin A supplementation program estimates for solving VAD situation among children of 6-59 month.