Adequate vitamin A liver stores estimated by the Modified-Relative Dose Response test are positively associated with breastfeeding but not vitamin A supplementation in Senegalese urban children 9-23 months old: a comparative cross-sectional study

<p><span><span><span><span><span><span><span><span><span><span><span>Vitamin A supplementation (VAS) in 6-59 month old children is recommended but its sustainability is currently questioned. In Senegal, data suggest that VAS should be maintained, but geographic and age-related specificities need to be addressed by gathering more evidence on the impact of this program. The objective of this comparative cross-sectional study, conducted in urban settings of Dakar, was to evaluate the effectiveness of VAS on vitamin A liver stores (VALS) among 9-23 month old children. The supplemented group (n = 119) received VAS (either 100 000 UI or 200 000 UI) 2 to 6 months before evaluation while the non-supplemented group (n = 110) had not received VAS during the past 6 months. VALS were assessed using the modified-relative dose response (MRDR) test. Serum retinol concentrations (SR) and biomarkers of subclinical inflammation were measured. Children's health-related data and feeding patterns were collected. Mean MRDR values (VAS: 0.030 ± 0.017, non-VAS: 0.028 ± 0.016, P = 0.39) and inflammation-adjusted SR (VAS: 1.34 ± 0.37, non-VAS: 1.3 ± 0.35, P = 0.51) of children were adequate. Low prevalence of VALS (VAS: 5.2%, non-VAS: 5.4%) and inflammation-adjusted VAD (VAS: 2.6%, non-VAS: 0.9%) were detected despite high presence of infections and inflammation. Children were mostly still being breastfed (VAS: 85.7%, non-VAS: 77.3%) and complementary feeding indicators were similar in both groups. Only breastfeeding was associated with VALS (adjusted OR = 0.24, 95% CI: 0.07-0.8, P = 0.02). Based on MRDR values, VAS was not related to improved VALS and SR as well as VAD reduction among these children with adequate VALS. Reinforcing breastfeeding advocacy and morbidity prevention/control are essential in this setting. Scaling-back VAS in this subpopulation should be examined regarding the risk of hypervitaminosis A. However, an evaluation of dietary VA intake sufficiency and a more quantitative assessment of VALS should be prior considered.</span></span></span></span></span></span></span></span></span></span></span></p>