Vitamin A Deficiency and Child Mortality in Cameroon: The Challenge Ahead

In Cameroon the under-five mortality rate is estimated at 151. The national vitamin A deficiency (VAD) survey conducted in 2000 revealed that 40 per cent of children were vitamin A deficient (serum retinol concentration < 0.70 mmol/l). The risk of death in children 6–59 months old with VAD is 1.75 times higher than that in children without VAD. The potential contribution of VAD to child mortality in Cameroon was estimated using the following equation: PAR = PREV (RR-1)/1+ [PREV (RR-1)]; where PAR (population attributable risk) is the proportion of all-cause under five mortality attributable to VAD; PREV is the observed VAD prevalence in under-fives (40 per cent); and RR (relative risk) is the increased risk of death in under-fives with VAD relative to those without VAD (1.75). Our analysis shows that in the absence of appropriate policy and program action an estimated 937 600 Cameroonian under-fives would be vitamin A deficient and VAD would be the attributable cause of about 12 000 deaths of children 6–59 months old annually. Effective VAD-control could reduce under-five mortality by up to 23 per cent from 1998 mortality levels (before the onset of large-scale vitamin A supplementation programs). (excerpt)