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Acta Trop. 2005 Mar;93(3):275-82.

Vitamin A supplementation during war-emergency in Guinea-Bissau 1998-1999.

Author information

1
Bandim Health Project, Apartado 861, 1004 Bissau Codex, Guinea-Bissau, West Africa. nls@ssi.dk

Abstract

BACKGROUND:

Vitamin A supplementation is recommended by WHO in emergency situations.

OBJECTIVE:

To evaluate the impact of Vitamin A supplementation on childhood mortality in an emergency situation.

DESIGN:

Since this was not a randomised study, we evaluated the impact in different ways; we used the variation in the delay of provision of Vitamin A in a step-wedged design, compared wartime with pre-wartime mortality and examined whether Vitamin A as a free commodity reduced cultural and social-economic inequalities in childhood mortality.

SUBJECTS:

5926 children 6 months to 5 years of age, resident in four suburbs in the capital of Guinea-Bissau between October 1, 1998 and March 31, 1999.

INTERVENTIONS:

From October 1, 1998 until the end of the war in 1999 all children present in the study area were offered Vitamin A at regular three-monthly visits to their homes.

RESULTS:

Using the variation in the provision of Vitamin A, we found a slight non-significant reduction in mortality for children between 6 months and 5 years of age (mortality ratio (MR) 0.49; 95% CI 0.09-2.70). Comparing with a three-year period before the war, children offered Vitamin A at home during the war had a 12% reduction in mortality (MR 0.88; 0.41-1.87), whereas the overall impact of the war was an 89% increase in mortality (MR 1.89; 1.32-2.71). Vitamin A supplementation was associated with a reduction in cultural and socio-economic inequalities.

CONCLUSIONS:

Vitamin A supplementation may have a beneficial impact on childhood mortality in an emergency situation.

[Indexed for MEDLINE]

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