ZAMBIA Last Updated: 2007-12-13

Vitamin and Mineral Nutrition Information System (VMNIS) WHO Global Database on Vitamin A Deficiency The Vitamin A Deficiency database includes data by country based on xerophthalmia and/or serum or plasma retinol concentration

Prevalence of xerophthalmia (%) Serum / plasma retinol concentration (µmol/l)

Prevalence (%) Reference Notes Age Sample Mean SD Level Date Location and sample descriptor Sex (years) size Current Previous X1B X2 X3A X3B XS <0.35 <0.70 < 1.05 XN XN General Line N 2003 National: NPW F 15.00-49.99 527 2.30 5098 * National: Pre-SAC: Total B 0.50-4.99 659 5.0 54.1 0.71 0.25 1 National: NPW F 15.00-49.99 583 13.444.6 1.13 0.41 Pre-SAC by phase: July B 0.50-4.99 317 5.7 53.3 0.72 0.26 Pre-SAC by phase: November B 0.50-4.99 342 4.3 54.7 0.71 0.24

L 2003 Six ADP's: Pre-SAC B 2.00-5.99 974 0.60 5102 * Six ADP's: Pre-SAC B 0.50-4.99 1514 0.60

D 2003 6 districts: Pre-SAC: Total B 2.00-5.99 745 3.76 5257 * 2 6 districts: Women: Total F 15.00-49.99 591 9.80 Pre-SAC by stratum: 1 B 2.00-5.99 335 1.49 3 Pre-SAC by stratum: 2 B 2.00-5.99 196 2.55 4 Pre-SAC by stratum: 3 B 2.00-5.99 214 8.41 5 Women by stratum: 1 F 15.00-49.99 233 9.00 Women by stratum: 2 F 15.00-49.99 133 10.50 Women by stratum: 3 F 15.00-49.99 225 10.20

L 2001P Ndola city: LW B 18.00-55.99 152 38.0 1.20 0.35 4273 * N 1997 National: Pre-SAC B 2.00-6.07 967 6.20 1325 * National: Women F 15.00-49.99 2328 11.60 National: Pre-SAC B 0.00-4.99 900 11.7 65.7 0.64 National: Women F 15.00-49.99 921 2.0 21.5

D 1996P Nkwazi residental area: Pre-SAC B NS 381 5.8 0.68 0.24 1961 * Chibolele residental area: SAC B 7.00-15.99 126 0.0 1.09 0.33 Chifubu residental area: SAC B 7.00-15.99 21 0.0 1.00 0.35 Kabwata residental area: SAC B 7.00-15.99 59 0.0 1.00 0.28 Kansenshi residental area: SAC B 7.00-15.99 101 0.0 1.23 0.29 Lumano residental area: SAC B 7.00-15.99 35 0.0 0.95 0.23 Masala residental area: SAC B 7.00-15.99 91 1.1 1.18 0.33

D 1994 Samfya district: Infants B 0.50-0.74 83 64.0 0.66 0.20 4231 * Samfya district: Pre-SAC B 1.17-1.66 78 55.0 0.71 0.20

D 1985 Luapula Valley: Pre-SAC: Total B 0.00-5.99 4275 0.44 0.68 214 * 6 Luapula Valley: Pre-SAC: Total B 0.00-5.99 2690 1.26

© WHO Global Database on Vitamin A Deficiency Vitamin and Mineral Nutrition Information System (VMNIS) WHO Global Database on Vitamin A Deficiency The Vitamin A Deficiency database includes data by country based on xerophthalmia and/or serum or plasma retinol concentration

ZAMBIA Last Updated: 2007-12-13

Prevalence of xerophthalmia (%) Serum / plasma retinol concentration (µmol/l)

Prevalence (%) Reference Notes Age Sample Mean SD Level Date Location and sample descriptor Sex (years) size Current Previous X1B X2 X3A X3B XS <0.35 <0.70 < 1.05 XN XN General Line

D 1985 Pre-SAC by age B 0.00-0.49 373 0.00 0.00 214 7 Pre-SAC by age B 0.50-0.99 347 0.00 0.58 8 Pre-SAC by age B 1.00-1.99 782 0.26 0.26 9 Pre-SAC by age B 2.00-3.99 1466 0.27 1.02 10 Pre-SAC by age B 4.00-5.99 1307 0.99 0.77 11 Pre-SAC by district: Kawambwa B 0.00-5.99 647 0.00 0.62 12 Pre-SAC by district: Mwense B 0.00-5.99 1086 0.09 0.55 13 Pre-SAC by district: Nchelenge B 0.00-5.99 2542 0.75 0.71 14

Reference No: 5098 General notes: Non-stratified cluster survey in 2 phases; phase 1) July and phase 2) November 2003. Same clusters but not necessarily same households used in both phases. Sample includes NPW who had given birth in the 3 years preceding the survey. Previous XN is defined as difficulty seeing at night but not in the day.

Note 1 Median: 0.68 µmol/L

Reference No: 5102 General notes: Baseline values of supplementation study. Two-stage PPS cluster sampling. Sample comprised of 1156 households randomly selected from clusters in nine Area Development Programs located within six districts (Sinazongwe, Gwembe, Chipata, Mbala, Mpika, Mongu) throughout Zambia. Night blindness assessed by asking mothers if their child had difficulty seeing at dusk/night time. Reference No: 5257 General notes: Two-stage PPS cluster sampling stratified by 3 strata: drought prone, borderline and non-drought prone. 6 districts (Itezhitezhi, Luangwa, Sinazongwe, Kalabo, Shangombo and Chinsali) selected based on the findings from the Vulnerability Assessment Study carried out in April 2003. Stratum 1) drought prone districts, stratum 2) borderline districts and stratum 3) non- drought prone district. Sample includes women who have had a live birth in the year preceding the survey. Note 2 XN prevalence adjusted for daytime visual problems: 0.40%

Note 3 XN prevalence adjusted for daytime visual problems: 0.00% Note 4 XN prevalence adjusted for daytime visual problems: 0.51% Note 5 XN prevalence adjusted for daytime visual problems: 0.93%

Reference No: 4273 General notes: Facility based study (clinic). Sample comprised of LW randomly selected from the mothers bringing their children to the under five clinic at Nkwazi council clinic, Ndola city. Serum retinol concentrations converted from µg/dL to µmol/L. Reference No: 1325 General notes: Multi-stage PPS cluster sampling. Summary data reported in reference No. 5089. Serum retinol concentrations converted from µg/dL to µmol/L. Reference No: 1961 General notes: Sample comprised of randomly selected pre-SAC/SAC from urban residential areas within Ndola district, namely Kansenshi, Masala, Chifubu, Chibolele, Kabwata, Lumano and Nkwazi. Children with malaria parasites and worms excluded. Summary data reported in references No. 30 and 195. Reference No: 4231 General notes: Facility based study (clinics). Sample comprised of infants/pre-SAC attending the mobile Mother-and-Child Health clinics from 12 randomly selected villages in the district of Samfya, Luapula province. Baseline data before clinical study on growth. Reference No: 214 General notes: Two-stage PPS cluster sampling. The Luapula Valley (Nchelenge, Kawambwa and Mwense districts), Luapula province. Summary data reported in reference No. 183. Note 6 Combined prevalence (X3A, X3B): 0.02%

Note 7 Combined prevalence (X3A, X3B): 0.00%, XN prevalence (sample size: 33): 0.00% Note 8 Combined prevalence (X3A, X3B): 0.00%, XN prevalence (sample size: 37): 0.00% Note 9 Combined prevalence (X3A, X3B): 0.13%, XN prevalence (sample size: 257): 1.17% Note 10 Combined prevalence (X3A, X3B): 0.00%, XN prevalence (sample size: 1180): 0.76% Note 11 Combined prevalence (X3A, X3B): 0.00%, XN prevalence (sample size: 1183): 1.86%

Note 12 Combined prevalence (X3A, X3B): 0.00%, XN prevalence (sample size: 434): 1.84% Note 13 Combined prevalence (X3A, X3B): 0.00%, XN prevalence (sample size: 706): 0.71% Note 14 Combined prevalence (X3A, X3B): 0.04%, XN prevalence (sample size: 1550): 1.36%

Reference 214 Sukwa T, Mwandu D, Kapui A, Siziya S, Vamoer A, Mukunyandela M, Chelemu V. The prevalence and distribution of xerophthalmia in preschool children of the Luapala Valley, Zambia. Journal of Tropical Pediatrics, 1988, 34 :12-15.

Reference 1325 Luo C, Mwela CM. National Survey on Vitamin A Deficiency in Zambia: a random cluster study for children (0-5 years) and mothers attending national immunization days in August 1997. Lusaka, National Food and Nutrition Commission, 1997.

Reference 1961 Kafwembe EM, Mwandu D, Sukwa Y. Socio-economic status and serum vitamin A levels in Zambian children. Central African Journal of Medicine, 1996, 42 :70-72.

Reference 4231 Hautvast JLA, Tolboom JJM, Willems JL, Mwela CM, Monnens LAH. Consequences of infections for three-month length increment in young children in rural Zambia. Acta Paediatrica Scandinavica, 2000, 89 :296-301.

Reference 4273 Kafwembe EM. Iron and vitamin A status of breastfeeding mothers in Zambia. East African Medical Journal, 2001, 78 :454-457.

Reference 5098 Micronutrient Operational Strategies and Technologies (MOST), UNICEF, Centers for Disease Control and Prevention, Food and Nutrition Commision of Zambia, University of Zambia. Report of the national survery to evaluate the impact of vitamin A interventions in Zambia, July and November 2003. Zambia, Micronutrient Operational Strategies and Technologies, United States Agency for International Development (USAID) Micronutrient Program, 2003.

Reference 5102 Klaas N. Vitamin A add-on program: first annual report March 2003. Mississauga, Ontario, World Vision Canada, 2003.

Reference 5257 Nzala SH, Mwale B, Nkombo N, Gegout C. Health impact survey, Zambia, 2003. Zambia, 2003.

Reference 30 Mwandu D, Underwood B et al. Rapid appraisal of community vitamin A status through school children. 1989.

Reference 192 Kamfewembe EM. Vitamin A deficiency disorders (VADD) symposium in Zambia. Sight and Life Newsletter, 2004, 3 :38-41.

Reference 1620 McCullough FS, Friis-Hansen B. Report on the health and nutrition scheme. Fort Rosebery, Northern Rhodesia 1957-1958. World Health Organization, Regional Office for Africa, .

Reference 2074 Underwood B. Review of the vitamin A and micronutrient programme Zambia. 1993.

Reference 2083 Opportunities for Micronutrient Interventions. Zambia's vitamin A program: a model for Africa. 1998.

Reference 4256 Hautvast JL, Tolboom JJ, West CE, Kafwembe EM, Sauerwein RW, van Staveren WA. Malaria is associated with reduced serum retinol levels in rural Zambian children. International Journal for Vitamin and Nutrition Research, 1998, 68 :384-388.

Reference 4874 Food Security, Health and Nutrition Information System, Central Statistical Office Labour Division, UNICEF. Zambia 1999 Multiple Indicator Cluster Survey report: report on the monitoring of the End of Decade Goals. Lusaka, Food Securiy, Health and Nutrition Information System, 1999.

Reference 5089 Micronutrient Operational Strategies and Technologies (MOST), United States Agency for International Development (USAID) Micronutrient Program. Zambian national strategy plan of action for the prevention and control of vitamin A deficiency and anemia, 1999-2004. Arlington, VA, United States Agency for International Development, 2004.