Chehab Elizabeth Tangel, Anya Blanche-Philomene Melanga, Onyango Adelheid Werimo, Tevi-Benissan Mable Carole, Okeibunor Joseph, Mkanda Pascal, Mihigo Richard
Center for Disease Prevention and Control, USA.
World Health Organization, Regional Office for Africa, Brazzaville, Congo.
Vaccine. 2016 Oct 10;34(43):5199-5202. doi: 10.1016/j.vaccine.2016.05.056. Epub 2016 Jun 27.
Vitamin A deficiency is a public health problem that affects children across the WHO African Region. Countries have integrated vitamin A supplementation in different child health interventions, most notably with polio campaigns. The integration of vitamin A in polio campaigns was documented as a best practice in Angola, Chad, Cote d'Ivoire, Tanzania, and Togo. There are potential risks to vitamin A supplementation associated with the polio endgame and certification in the African Region.
We reviewed the findings from the documentation of best practices assessment that was conducted by the WHO Regional Office for Africa in 2014 and 2015 in the five countries that noted integration of vitamin A with polio as a best practice. In addition, we reviewed the coverage rates for oral poliovirus vaccine and vitamin A supplementation in Angola, Chad, Cote d'Ivoire, Tanzania, and Togo in 2014 and 2015.
Vitamin A deficiency in 2004 ranged from 35% in Togo to as high as 55% in Angola. All five countries integrated vitamin A supplementation in at least one campaign in 2013-2014 and all achieved over 80% coverage for vitamin A supplementation when it was integrated with polio.
Given the progress of the polio program, and decreasing campaigns, there is a risk that fewer children will be reached each year with vitamin A supplementation. We recommend that for countries strengthen the integration of vitamin A supplementation with routine immunization services.
维生素A缺乏是一个影响世卫组织非洲区域儿童的公共卫生问题。各国已将维生素A补充剂纳入不同的儿童健康干预措施中,最显著的是与脊髓灰质炎运动相结合。在安哥拉、乍得、科特迪瓦、坦桑尼亚和多哥,维生素A与脊髓灰质炎运动的整合被记录为最佳实践。在非洲区域,与脊髓灰质炎终结和认证相关的维生素A补充存在潜在风险。
我们回顾了世卫组织非洲区域办事处2014年和2015年在五个将维生素A与脊髓灰质炎整合视为最佳实践的国家进行的最佳实践评估文件中的调查结果。此外,我们还回顾了2014年和2015年安哥拉、乍得、科特迪瓦、坦桑尼亚和多哥口服脊髓灰质炎疫苗和维生素A补充剂的覆盖率。
2004年维生素A缺乏率在多哥为35%,在安哥拉高达55%。所有五个国家在2013 - 2014年至少在一次运动中纳入了维生素A补充剂,并且当与脊髓灰质炎运动整合时,所有国家的维生素A补充剂覆盖率均超过80%。
鉴于脊髓灰质炎计划的进展以及运动次数的减少,存在每年接受维生素A补充剂的儿童数量减少的风险。我们建议各国加强维生素A补充剂与常规免疫服务的整合。