We examined the determinants of dietary vitamin A intake among Sudanese children, information which is important for designing effective interventions based on the dietary approach. Children under the age of two years were at greater risk of consuming a diet low in vitamin A compared with children who were five years or older. Compared with children from relatively affluent households, those from poorer households were about twice as likely to consume low levels of carotenoid or preformed vitamin A. Low vitamin A intake was also significantly associated with lack of running water, a latrine, radio, or television in the household, and inversely associated with maternal or paternal illiteracy and with cleanliness of the child subjectively assessed by the interviewer. As expected, breastfed children in the first two years of life were likely to consume lower levels of preformed vitamin A and carotenoid from food (excluding breast milk) compared with non-breastfed children. Low vitamin A intake was more prevalent in the dry months of the year. Efforts to increase accessibility to vitamin A containing food, combined with nutrition education campaigns and public health programmes directed at improving sanitation and reducing infection are necessary as part of the long-term solution to the problem of vitamin A deficiency.
PIP: Although the importance of vitamin A as a nutrient for child survival and health has been known for a long time, vitamin A deficiency continues to be a public health problem. Approximately 2.8 million children aged 0-4 years have xerophthalmia and another estimated 251 million have moderate to severe subclinical deficiency. Findings are reported from an investigation of the determinants of dietary vitamin A intake among 28,753 Sudanese children aged 6-72 months. The study was placebo-controlled and spanned a 2-year follow-up period. Children under age 2 years were at greater risk of consuming a diet low in vitamin A compared with children aged 5 years or older, while children from relatively poor households were about twice as likely to consume low levels of carotenoid or preformed vitamin A. Low vitamin A intake was also significantly associated with lack of running water, a latrine, radio, or television in the household, and inversely associated with maternal or paternal illiteracy and with cleanliness of the child as subjectively assessed by the interviewer. Children breast fed during their first 2 years of life were likely to consume lower levels of preformed vitamin A and carotenoid from food (excluding breast milk) relative to non-breast-fed children, and low vitamin A intake occurred more during the dry months of the year. A need exists to increase accessibility to vitamin A-containing foods and to have nutrition education campaigns and public health programs directed at improving sanitation and reducing infection as part of the long-term solution to vitamin A deficiency.