Vitamin A Deficiency in Children Clinical Trial
Official title:
The Effect of Biscuits Containing Red Palm Oil on School Children With Vitamin A Deficiency in West and East Malaysia
Based on recent nutrition survey (SEANUTS Malaysia) on a total of 3542 Malaysian Children aged between 6 months to 12 years old, 4.4% of the children had vitamin A deficiency. Rural areas recorded a higher prevalence of vitamin A deficiency (6.4%) compared with urban areas (3.8%). Besides, prevalence of iron deficiency due to low ferritin concentrations is 4.4% and anaemia based on low haemoglobin concentrations is 6.6%. It is proposed that a red palm oil intervention programme to be conducted in alliance with RMT in Malaysia to enhance the Vitamin A status of school children in underprivileged community in Malaysia.
Deficiency of vitamin A or retinol is a public health problem and listed as the most
widespread nutritional deficiency worldwide (Sommer, 1995). According to the World Health
Organization (WHO), about 190 million preschool children in underdeveloped countries
especially in the region of Africa and South-East Asia are vitamin A deficient (2011, 2011).
Infants and children have higher vitamin A requirements to promote rapid growth and better
immunity to combat infections. Vitamin A deficiency in children causes visual impairment and
blindness, risk of infection, stunting, anemia, respiratory diseases and mortality due to
common childhood infections such as diarrhea and measles. On the basis on Cochrane
meta-analysis on 194,795 children, vitamin A supplementation could reduce childhood mortality
by 23% and incidences of illnesses (Imdad et al., 2010).
According to WHO, an estimated 2.8 million preschool-age children are at risk of nutritional
blindness or active xerophthalmia due to Vitamin A deficiency in low-income countries
(Organization, 2010). Sadly, approximately 250 000 to 500 000 children suffering from vitamin
A deficiency become blind yearly, and half of the number die within a year of losing their
vision (Organization, 2010). The different eye signs of vitamin A deficiency (VAD) in
children as graded by the WHO are night blindness, conjunctival xerosis, Bitot's spots,
corneal xerosis, corneal ulcer/keratomalacia and corneal scarring (Sommer, 1995). Severe
vitamin A deficiency distresses ocular tissue by reducing regeneration of visual pigment upon
exposure to bright light or lasting damage on the epithelium of the cornea and conjunctiva.
Classical ocular manifestation due to vitamin A deficiency may lead to less serious Bitot's
spots and night blindness, or severe xerophthalmia and keratomalacia leading to blindness
(Scrimshaw, 2000). Ocular manifestation of vitamin A deficiency still exists in
underprivileged communities in Malaysia (Ngah et al., 2002). Vitamin A deficiency is
prevalent in pre-school and primary school children of aborigines ("Orang Asli") and those
from rubber estates. 82.2% of Orang Asli children had ocular manifestations of vitamin A
deficiency ranging from history of night blindness to corneal scars (Ngah et al., 2002).
Based on recent nutrition survey (SEANUTS Malaysia) on a total of 3542 Malaysian Children
aged between 6 months to 12 years old, 4.4% of the children had vitamin A deficiency. Rural
areas recorded a higher prevalence of vitamin A deficiency (6.4%) compared with urban areas
(3.8%) (Poh et al., 2013).
There is significant association between iron deficiency and vitamin A deficiency represented
by low serum retinol (Al-Mekhlafi et al., 2013). According to WHO, iron deficiency is the
commonest and widespread nutritional deficiency in the world. Over 30% of the world's
population are known to be anaemic due to iron deficiency, poor diet, or exposed to
infectious diseases. Malaria, HIV/AIDS, hookworm infestation, schistosomiasis, and other
infections such as tuberculosis are particularly important factors contributing to the high
prevalence of anaemia in some areas. Iron deficiency may lead to impaired health, development
and learning in children. Based on Malaysian SEANUTS survey, the overall prevalence of iron
deficiency due to low ferritin concentrations is 4.4% and anaemia based on low haemoglobin
concentrations is 6.6% (Poh et al., 2013). The occurrence of anaemia and iron deficiency
among Orang Asli children is relatively high. The Orang Asli children aged 2-15 years old,
living in eight villages in Selangor showed high episodes of anaemia 41.5% and 36.5% had iron
deficiency anaemia. In another recent study, nearly half (48.5%) of the Orang Asli children
from 18 villages in Pahang were found to be anaemic and the prevalence of iron deficiency was
34% (Al-Mekhlafi et al., 2013).
In Malaysia, the school-feeding program is called "Rancangan Makanan Tambahan (RMT)" which
literally means additional food plan. The RMT program is provided only to primary school
children (aged 6 - 12 years) from poor families. It is not meant to replace food served at
home, but to provide extra nourishment for children from poor families. The RMT program is
managed by the School Division of the Ministry of Education, Malaysia. Food is served during
recess time (10.30 a.m. for morning session, and 3.30pm for afternoon session) and provides
1/4 to 1/3 of daily requirements. It is proposed that a red palm oil intervention programme
to be conducted in alliance with RMT in Malaysia to enhance the Vitamin A status of school
children in underprivileged community in Malaysia.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
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N/A | |
| Completed |
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