e-Library of Evidence for Nutrition Actions (eLENA)


An online library of evidence-informed guidelines for nutrition interventions and single point of reference for the latest nutrition guidelines, recommendations and related information.

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Vitamin A supplementation in HIV-infected infants and children 6–59 months of age

Intervention | Last updated: 19 May 2023


Vitamin A deficiency affects about 190 million preschool-age children, mostly from Africa and South-East Asia. In infants and children, vitamin A is essential to support rapid growth and to help combat infections. Inadequate intakes of vitamin A may lead to vitamin A deficiency which can cause visual impairment in the form of night blindness, may increase the risk of illness and death from childhood infections, and may compound the effects of HIV infection.

Research has shown that vitamin A supplementation in HIV-infected infants and children is safe and effective in reducing illness and death. Vitamin A can be safely provided to children in a large dose, rather than more frequent smaller doses, as it can be stored by the body and released over time as needed.

Many countries have successfully integrated strategies to deliver vitamin A supplements to infants and children in their national health policies, including delivery during routine health visits and immunizations.

WHO Recommendations


In settings where vitamin A deficiency is a public health problem (prevalence of night blindness is 1% or higher in children 24–59 months of age or where the prevalence of vitamin A deficiency (serum retinol 0.70 µmol/l or lower) is 20% or higher in infants and children 6–59 months of age), high-dose vitamin A supplementation is recommended in infants and children 6–59 months of age.

The above recommendation can also be applied in populations where infants and children may be infected with HIV.

 



Evidence


Systematic reviews used to develop the guidelines


Micronutrient supplementation in children and adults with HIV infection

Irlam JH, Visser MME, Rollins NN, Siegfried N. Cochrane Database of Systematic Reviews. 2010; Issue 12. Art. No.: CD003650.

Summary of this review Alternate Text

Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age

Imdad A, Herzer K, Mayo-Wilson E, Yakoob MY, Bhutta ZA. Cochrane Database of Systematic Reviews. 2010; Issue 12. Art. No.: CD008524.

Summary of this review Alternate Text

Related Cochrane reviews


Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age.

Imdad A, Mayo‐Wilson E, Herzer K, Bhutta ZA. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No.: CD008524.


Micronutrient supplementation for children with HIV infection

Irlam JH, Siegfried N, Visser ME, Rollins NC. Cochrane Database of Systematic Reviews. 2013; Issue 10. Art. No.: CD010666.

Summary of this review Alternate Text

Cost-effectiveness Learn More Alternate Text


Cost-effectiveness analyses


Using cost-effectiveness analysis to evaluate targeting strategies: the case of vitamin A supplementation

Loevinsohn BP, Sutter RW, Costales MO. Health Policy Plan. 1997; 12(1):29-37.


The costs and effectiveness of three vitamin A interventions in Guatemala

Phillips M, Sanghvi T, Suárez R, McKigney J, Fiedler J. Soc Sci Med. 1996; 42(12):1661-8.


Cost effectiveness analysis of strategies for child health in developing countries

Edejer TT, Aikins M, Black R, Wolfson L, Hutubessy R, Evans DB. BMJ. 2005; 331(7526):1177.


Cost-effectiveness analysis (CEA) regarding vitamin A in children aged less than 5 years-old in Colombia

Quitian H, Castaño N, Granados C, Gómez-Restrepo C. Rev Salud Publica (Bogota). 2014; 16(3):408-16. [Article in Spanish]