Large dose vitamin A to control vitamin A deficiency.

Vitamin A deficiency is a serious problem throughout the developing world. An estimated 25-50 million children may well suffer the physiologic consequences of vitamin A deficiency; 5 million develop xerophthalmia, of whom 250,000 to 500,000 go blind every year; and untold numbers are at increased risk of diarrhea, respiratory disease, and death. Even mild vitamin A deficiency has been associated with a 14- to 10-fold increase in mortality, and controlled field trials have demonstrated vitamin A supplementation can reduce childhood death rates by 30%-70%. Three general intervention strategies exist for improving vitamin A status of high-risk, rural, economically deprived populations. These include nutrition education leading to increased dietary intake; vitamin A fortification of centrally processed, widely consumed dietary items; and periodic administration of large doses of vitamin A. At present, the latter is far and away the most widely employed intervention activity, because of its immediate impact, and because it can be implemented through the existing (and specialized) health care infrastructure. Vitamin A is a fat-soluble vitamin stored in the liver, so that a large dose of 200,000 IU (100,000 IU for children under 1 year of age) every 6 months reduces mortality, stimulates growth, and prevents xerophthalmia and nutritional blindness. Recent data suggest more frequent administration, every 3 to 4 months, may be desirable. Side effects have been minimal, with mild nausea, vomiting, and headaches in less than 1% to 4% of recipients. Care should be taken, however, that doses above 10,000 IU not be administered to women during the first trimester of pregnancy because of potential teratogenic effects.(ABSTRACT TRUNCATED AT 250 WORDS)