Vitamin A supplementation and child survival: magic bullet or false hope?

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Abstract
Vitamin A deficiency is a common problem in many of the poorer countries of the world, especially in Asia and certain parts of Africa. Vitamin A deficiency causes xerophthalmia, a potentially blinding eye condition, and it has been estimated that at least 500 000 of the world's children develop severe corneal xerophthalmia each year, 50% of whom will later become blind; three-quarters of this 50% die within a few months of becoming blind. This paper summarizes the epidemiology of vitamin A deficiency in the world, both in terms of its geographical distribution and some important risk factors for its occurrence. Evidence on the relationships between vitamin A deficiency, xerophthalmia and mortality and non-visual morbidity are discussed, with the conclusion that, although strong associations undoubtedly exist, causality has not been proved conclusively. Methods of intervention to improve vitamin A status at a population level - periodic administration of large doses of vitamin A, food fortification and dietary modifications - are then considered

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