There is a proposal
to link massive dose Vitamin A prophylaxis with pulse polio immunization
in under-five children. The members of the IAP Subspecialty Chapter
on Nutrition carefully deliberated the merits and demerits of
this proposal. It was opined that:
- There is unambiguous evidence
of appreciable secular decline in clinical Vitamin A deficiency
in under-five children in the country.
- Recent data indicates that
Vitamin A supplementation in infancy does not have any beneficial
effect on growth, morbidity and mortality.
- 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 Subspecialty Chapter on Nutrition recommended 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 Subspecialty Chapter on Nutrition,
Department of Pediatrics, Maulana Azad Medical College, New Delhi
110 002, India. Email: jiap@ren.nic.in
|
|
