The JiVitA project

Things are on full speed here — getting a visa, vaccines, tickets, etc. — so I should be ready to head over later this month. I’ve gotten some good news about the living situation — most importantly, I’ll have good access to internet.

A good description of the project is in this article (on page 10). In a nutshell the first part of the study (JiVitA-1) will attempt to replicate results from a trial done in Nepal where vitamin A supplementation reduced maternal mortality (i.e. the number of deaths of mothers during pregnancy and childbirth) by a quite amazing 44%.

A total of 110 thousand women are being followed (to see if they are pregnant) and eventually 67 thousand will be enrolled in the study (we are already up to 66 thousand). A second trial (JiVitA-2) is nested within the first one and examines the effects of Vitamin A supplementation on around 23 thousand of the newborns born to the mothers in JiVitA-1. The project has around 850 employees, over 95% of which are local women that were trained by the research team.

To give everybody the background, vitamin A has been a huge success story in public health. The enormous effect of Vitamin A Deficiency on children’s health was first recognized by Al Sommer, former dean of JHBSPH. Here is the story of the first findings; the impact:

Their work showed that ensuring adequate vitamin A intake can mitigate the effects of common diseases such as measles and diarrhea; reduce child mortality in at-risk populations by 23 to 34 percent to avert up to one million deaths a year; and prevent as many as 400,000 cases of childhood blindness each year.

and

Today, 127 million pre-school children and 7 million pregnant women are vitamin A deficient. Every year, between 250,000 and 500,000 children go blind from a lack of vitamin A in their diet, which also affects their growth, cognitive development and immune system. 70% of these children die within one year of losing their sight, and a total of 800,000 children every year from a lack of vitamin A.

Yet, supplementation with vitamin A capsules is the single most cost-effective health intervention according to the World Bank and other global health experts. It only takes two doses a year to prevent blindness – at a cost of approximately $1.

The Vitamin A capsules are currently being given to tens of millions of children per year (see f.e. this story from Bangladesh) and, with the large percentage reduction, this means hundreds of thousands of lives saved per year (so, who wants to be Al Sommer?). The effects on children have been well established but the impact on maternal health is less known (although the Nepal trial gives high hopes), and hence JiVitA-1.

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