Saturday, October 29, 2011

Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5

According to the World Health Organization, more than 10 million children die each year, almost all in low-income countries or poor areas of middle-income countries, most from one of a short list of causes: diarrhea, pneumonia, measles, malaria, HIV/AIDS, and the underlying cause of undernutrition for deaths among children younger than 5 years. Poverty is always given as the culprit, but I say it's the dysfunctional governments in those countries, many with leaders who have great wealth contributed by gullible western governments who've accepted promises the millions in aid payments will be used for roads, schools or clean water. Clean water and nutritional supplementation could solve a lot on this list. DDT could take care of malaria until a vaccine is found. A stable government could also help with the HIV/AIDS problem if millions of men stayed home rather than travel for work.

WHO estimates, for example, among children living in the 42 countries with 90% of child deaths, a group of effective nutrition interventions including breastfeeding, complementary feeding, vitamin A, and zinc supplementation could save about 2·4 million children each year (25% of total deaths). Effective and integrated case management of childhood infections (diarrhea and dysentery, pneumonia, malaria, and neonatal sepsis) could save 3·2 million children each year (33% of total deaths). Breastfeeding is on the list, I assume, because it's dangerous to use formula when you don't have safe water.

I wish I could say I don't understand why black and brown children in developing countries are still being used like lab rats for vitamin studies by westerners when we've known for nearly 100 years the importance of Vitamin A, and how to supplement food with it since the 1930s. This particular data report published in the British Medical Journal which looked at 43 studies says using placebo trials is unethical because of the high mortality rate for the children who didn't get the supplements.

But the mortality figures don't even begin to factor the blindness and other illnesses. American children have been eating vitamin fortified foods since the 30s and 40s, plus mothers have been getting prenatal vitamins at least since I was pregnant 50 years ago, and maybe longer, and children have been receiving vitamin tablets for over 50 years, so why not just give the African or Asian children a multivitamin tablet high in vitamin A and save the cost of the study? Well, there it is. People make a living doing these studies. Research centers publish results in journals which need advertising revenue. Pharmaceutical companies need reasons to provide the testing material. Meanwhile, a lot of children die or are damaged the rest of their lives for want of a tablet that costs pennies a day.

Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis -- Mayo-Wilson et al. 343 --

How many child deaths can we prevent this year?

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