Vitamin A has well recognised benefits for the reduction in severity of diarrhoeal episodes but the impact of therapeutic doses given during diarrhoea on the biochemical and clinical outcomes is less clear. In this study these potential therapeutic benefits were investigated to establish the optimum time for vitamin A supplementation to improve vitamin A status. Establishing the optimum time for vitamin A supplementation during an infectious stage would improve cost effectiveness and clinical benefit. Young children (174) between the ages of 3 and 60 months with severe diarrhoea were randomised in a double - blinded placebo controlled trial into one of 2 groups. The 1 st group received 60 mg of retinol as retinyl palmitate on admission during the acute diarrhoeal stage. The 2nd group received the same dose of vitamin A once symptoms had resolved, usually between 3 - 7 days. At each of these two time points, children not receiving vitamin A were given an identical placebo dose. Baseline (day 0) and day 3 serum samples were collected for vitamin A, retinol binding protein (RBP) and other biochemical markers. At four and eight weeks after discharge both morbidity and weight gain were recorded. The modified dose response test (MRDR) was conducted at the eight - week follow - up to estimate vitamin A liver stores. Initially, most of the children presented with watery diarrhoea and dehydration and were clinically very ill. At day 3 plasma retinol concentrations improved in both groups viz. from 0.57umol/L to 0.97umol/L in the 1st group and from 0.49umol/L to 0.90umol/L in the 2nd group. Similar improvements were found in retinol binding protein viz. 21.28 mg/L to 31.06 mg/L in the 1st group and 17.05 mg/L to 24.80 mg/L in the 2nd group. At 8 weeks there was also no significant difference between the two groups either for serum retinol (0.69umol/L and 0.73umol/L respectively) nor for MRDR ratios (0.036 and 0.049 respectively). The MRDR results at 8 weeks indicated that these children did not have depleted vitamin A liver stores and that the low serum retinol levels seen at baseline were probably due to the acute phase response during an infectious episode. The results of these analyses showed no significant difference between the two treatment groups thus indicating that there was no benefit to giving vitamin A on recovery from an infectious episode instead of on admission, as is currently practised. / Thesis (M.Med.Sc.)-University of Natal, Durban, 2001.

The purpose of this study was to investigate the environmental factors that impact on childhood diarrhoea in children under five years old in Akakikality sub city Addis Ababa, Ethiopia. Objectives of the study were to determine the prevalence of diarrhoea and to determine the environmental factors that impact on diarrhoea in children under five years old. A survey was done and a non-experimental approach was used in this descriptive and analytical quantitative study using a cross sectional study design. The instrument was a self-designed questionnaire. The target population for this study was all mothers or caretakers of children under five years found in the described study context – the sample size was 299. In this study 12.7% of the children had diarrhoea during the survey. Proper utilization of toilets, hand washing and safe storage of water in the households using narrow mouthed water containers were significant predictors of diarrhoea in the children. / Health Studies / M.A. (Public Health)

The purpose of this study was to investigate the environmental factors that impact on childhood diarrhoea in children under five years old in Akakikality sub city Addis Ababa, Ethiopia. Objectives of the study were to determine the prevalence of diarrhoea and to determine the environmental factors that impact on diarrhoea in children under five years old. A survey was done and a non-experimental approach was used in this descriptive and analytical quantitative study using a cross sectional study design. The instrument was a self-designed questionnaire. The target population for this study was all mothers or caretakers of children under five years found in the described study context – the sample size was 299. In this study 12.7% of the children had diarrhoea during the survey. Proper utilization of toilets, hand washing and safe storage of water in the households using narrow mouthed water containers were significant predictors of diarrhoea in the children. / Health Studies / M.A. (Public Health)