There is a proposal to link massive dose Vitamin A
prophylaxis with pulse polio immunization in under-five children. The
members of the IAP Subspeciality Chapter on Nutrition carefully
deliberated the merits and demerits of this proposal. It was opined
that:
1. There is unambiguous evidence of appre-ciable
secular decline in clinical Vitamin A deficiency in under-five children
in the country.
2. Recent data indicates that Vitamin A
supplementation in infancy does not have any beneficial effect on
growth, morbidity and mortality.
3. It was felt that linking Vitamin A to the pulse
polio program is inappropriate; the routine program should not be
destabilized except under exceptional circumstances. Concerns were
expressed regarding the difficulties in keeping adequate records of
Vitamin A dosing, the distinct possibility of toxicity or side effects
due to multiple dosing within 6 months and the negative impact on
Vitamin A administration through the routine services as at present. The
changed strategy would mean that all nutrition and health workers would
have to be instructed to discontinue routine Vitamin A administration
and established systems for distribution of Vitamin A supplies would
become immobilized. When pulse polio program ceases to exist,
reinitiation of routine Vitamin A administration would have obvious
implications in terms of retraining, logistics and supplies.
In view of these considerations, the IAP
Subspeciality Chapter on Nutrition recom-mended that the proposal to
link Vitamin A administration to pulse polio program should not be
adopted.
This recommendation has been endorsed as the official Indian Academy
of Pediatrics policy on this issue.
Correspondence to: Chairperson, IAP
Subspeciality Chapter on Nutrition, Department of Pediatrics, Maulana
Azad Medical College, New Delhi 110 002, India. Email: [email protected]