Lessons from successful micronutrient programs. Part III: program impact.

摘要: Micronutrient-deficiency control programs have been greatly extended at the national level in last 10 to 15 years. However rigorous evaluations of these are scarce so that conclusions on impact tentative and based mainly indirect evidence. The coverage vitamin A capsule distribution has exceeded 70% most study countries. In countries implementing iodized salt reaches 60% 90% households with adequately salt. Of three micronutrients iron tablet supplementation is least well documented due inadequate program monitoring systems population survey data. Supplementation preschool children 6 59 months age capsules plausibly contributed reduction clinical deficiency its near-elimination many childrens biochemical status (serum retinol) may be less. National data iodization show a consistent relation reduced prevalence iodine-deficiency disorder symptoms (goiter); rates cretinism other results iodine almost certainly falling too. evaluation limited by lack Although trials demonstrated efficacy reducing anemia interpretation national-level not clear. Given substantial financial technical commitment required implement micronutrient-deficiency it vital investment enable programs. It becoming increasingly important collect subclinical (e.g. data) assess impact. (authors)