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Prevalence of Vitamin A Deficiency in South Asia: Causes, Outcomes, and Possible Remedies
Akhtar, Saeed; Ahmed, Anwaar; Randhawa, Muhammad Atif; Atukorala, Sunethra; Arlappa, Nimmathota; Ismail, Tariq & Ali, Zulfiqar
Abstract
Vitamin A deficiency (VAD) has been recognized as a public-health issue in developing countries. Economic
constraints, sociocultural limitations, insufficient dietary intake, and poor absorption leading to
depleted vitamin A stores in the body have been regarded as potential determinants of the prevalence
of VAD in South Asian developing countries. VAD is exacerbated by lack of education, poor sanitation,
absence of new legislation and enforcement of existing food laws, and week monitoring and surveillance
system. Several recent estimates confirmed higher morbidly and mortality rate among children and pregnant
and non-pregnant women of childbearing age. Xerophthalmia is the leading cause of preventable
childhood blindness with its earliest manifestations as night blindness and Bitot’s spots, followed by blinding
keratomalacia, all of which are the ocular manifestations of VAD. Children need additional vitamin
A because they do not consume enough in their normal diet. There are three general ways for improving
vitamin A status: supplementation, fortification, and dietary diversification. These approaches have not
solved the problem in South Asian countries to the desired extent because of poor governmental support
and supervision of vitamin A supplementation twice a year. An extensive review of the extant literature
was carried out, and the data under various sections were identified by using a computerized bibliographic
search via PubMed, Web of Science, and Google Scholar. All abstracts and full-text articles were examined,
and the most relevant articles were selected for screening and inclusion in this review. Conclusively, high
prevalence of VAD in South Asian developing countries leads to increased morbidity and mortality among
infants, children, and pregnant women. Therefore, stern efforts are needed to address this issue of publichealth
significance at local and international level in lower- and middle-income countries of South Asia.
Keywords
Blindness; Infections; Malnutrition; Vitamin A; South Asia
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