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Indian Pediatr 2021;58: 1094-1095 |
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Vitamin A Supplementation in Children in
Guédiawaye Health District, Senegal
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Jean Baptiste Niokhor Diouf,1* Ndèye Marième Sougou2
1Pediatrics Department of the Hospital Center Roi
Baudouin of Guédiawaye, and 2Department of Public Health, Institut de
Santé et Development (ISED); University of Cheikh Anta Diop, Dakar,
Senegal.
Email: [email protected]
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To assess the coverage rate of routine vitamin A supplementa tion, a
descriptive study was carried out in the Guédiawaye Health District. The
coverage rate for vitamin A supplementation was 48.6%. Age over 24
months, uneducated father, maternal age over 25, and lack of
disease-related knowledge were factors associated with delayed vitamin A
supplementation.
Keywords: Coverage, Health program, Under-5
children.
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Vitamin A deficiency remains a public health problem in developing
countries, particularly in Africa and the Indian subcontinent. It
affects young children, often associated with protein-energy
malnutrition, and pregnant women [1]. Vitamin A supplementation is
recommended in infants and children aged 6-59 months as a public health
intervention to reduce child morbidity and mortality [2]. In accordance
with this guideline, Senegal adopted vitamin A supplementation as a
strategy during routine immunization activities and mass campaigns,
since 2013. The objective of this study was to determine the coverage
rate for vitamin A supplementation among children 6-59 months of age in
the Guédiawaye Health District.
This community-based descriptive study was conducted
from 1 June to 30 November, 2018 in the Guédiawaye district. The
surveys relating to the characteristics of the child, the family and
knowledge about vitamin A supplementation concerned the households drawn
at the level of each stratum, using a systematic two-stage cluster
random sampling. The first stage consisted in selecting neighborhoods
within the geographical area of the district, and the second stage in
selecting households within the drawn neighborhoods. In each selected
household, all children aged 6-59 months were included in the survey.
Data collection was carried out by two trained investigators. Each
investigator was accompanied by a bajenou ngox, a neighborhood
godmother, to facilitate the interview. The parameters studied were: the
individual characteristics of the child (age, sex, position within
sibling, spacing interval between births), household
characteristics, and knowledge about vitamin A supplementation. A
written informed consent was obtained from the individual parent prior
to the survey.
The median age of fathers was 38 and that of mothers
28 years. The average household size was 7 people. Out of 366 children
aged 6-59 months surveyed, 188 (51.4%) had not received vitamin A. The
coverage rate was higher for children over 23 months of age (65.6%).
Before 12 months, coverage rate was 36.8% and between 12 and 23 months
64.6%. The characteristics of the households surveyed are summarized in
Table I. Age over 24 months [OR (95% CI) 3.41 (1.87-6.19); P<0.001],
father’s lack of education [OR (95% CI)1.49 (0.91-2.44); P=0.11],
maternal age over 25 year [OR (95% CI) 1.74 (1.01-3.02); P=0.04],
and lack of knowledge of means of protection against diseases [OR (95%
CI) 1.43 (0.83-2.44); P=0.19] were factors associated with
delayed vitamin A supplementation.
Table I Household Characteristics
| Characteristics |
No. (%) |
| Interviewee: |
|
| Mother |
182 (96.8) |
| Married |
176 (93.6) |
| Educated father |
139 (73.9) |
| Educated mother |
90 (47.9) |
| Mother employed |
66 (35.1) |
| Fathers occupation |
|
| Liberal profession |
129 (68.6) |
| Civil servant |
31 (16.5) |
| Worker |
18 (9.6) |
| Housing occupancy status |
|
| Tenant |
109 (58.0) |
| Family property |
47 (25.0) |
| Owner |
31 (16.5) |
| Free accommodation |
1 (0.5) |
| Main source of income |
|
| Trade |
146 (77.7) |
| Salary |
35 (18.6) |
| Other source |
7 (3.7) |
| Main source of stable income
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35 (18.6) |
| Main source of regular income
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35 (18.6) |
| Income amount per moa |
|
| 36000 – 72000 XOF |
2 (1.1) |
| Over 72 000 XOF |
3 (1,6) |
| Does not know |
178 (94.7) |
| arefused to answer.
XOF – West African CFA Franc. |
Improving the vitamin A status of under-5 children
increases their chance of survival by reducing mortality by 25% from
childhood illnesses such as malaria, diarrhea, acute respiratory
infections and measles [3]. Therefore, evaluating the coverage rate for
vitamin A supplementation and knowing the factors associated with
delayed supplementation help reduce under-5 morbidity and mortality. A
vitamin A supplementation coverage rate of 48.6% was found in this
study. This rate is lower than that found in the 2017 demographic and
health survey (57.4%) [7] and that of the local vitamin A
supplementation days (90.4% in June, 2011 and 93.5% in December, 2011)
[8]. In Mali, Sangho, et al. [9] found a 90% vitamin A supplementation
coverage rate in children. These higher coverage rates than that found
in this study do not reflect the results associated with routine vitamin
A supplementation because in these studies the surveys were carried out
immediately after supplementation campaigns. This proves that routine
vitamin A supplementation activities alone do not achieve the expected
coverage rates, hence the need to couple them with mass campaigns.
According to WHO, vitamin A supplements should be given to children 6 to
59 months of age twice a year, during contact with the health system
[2].
Children between 12 and 23 months of age and those
between 24 and 59 months of age were 3.53 times and 3.41 times, more
likely respectively to receive vitamin A than infants between 6 and 12
months of age, in this study. This could be due to vitamin A
supplementation being integrated into immunization activities in
Senegal, and that the older the child the more contact he has with these
services. Likewise, fathers’ lack of education and knowledge of
protective measures against diseases were associated with no vitamin A
supplementation. Fathers’ education was previously also reported to be
associated with vitamin A coverage of children in Mali [10]. Possibly
the role of fathers in healthcare decisions, and parental education
promoting better adherence to interventions are the reasons for these
findings.
This study reveals that vitamin A supplementation
coverage in routine activity seems low in the study area. Educating
parents and organizing mass campaigns could help improve coverage
rates.
Acknowledgment: Centre d’excellence africain pour
la santé de la mère et de l’enfant (CEA/SAMEF).
Ethics clearance: Research Ethics Committees,
Cheikh Anta Diop University of Dakar; No. 0260/2017/CER/UCAD dated May
22, 2017.
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