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NAVRONGO HEALTH RESEARCH CENTRE A Field station of the Ministry of Health, Ghana (Member of the INDEPTH Network)
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THE GHANA Vitamin A Supplementation Trial (Ghana VAST)
Investigators :Dr David Ross, Dr Fred Binka, Dr. Paul Arthur, Dr
Johnny Gyapong,
Collaboration :A collaborative study between the London School
of Hygiene and Funding :British ODA, Ghana Ministry of Health
Period Covered:03/1988 – 12/1991
BACKGROUND OBJECTIVES SUMMARY RESULTS
VAST was a collaborative study between the London School of Hygiene and Tropical Medicine (LSHTM) and the Department of Community Health of the University of Science and Technology (UST), Kumasi, with the support of the Ministry of Health Ghana and the British Government's Overseas Development Administration (Health and Population Division). The proposal for this study arose out of detailed discussions between all four parties during 1987, which included a visit to the Upper East Region of Ghana in December 1987 to select the site for the trial. The Kassena-Nankana District of Upper East Region was selected for the study, since xerophthalmia exists in the District, but there was no previous distribution of vitamin A within the District, except to two, small, clearly-defined populations. Both the Regional and District Health Administrative Authorities extended invitations to the study, and agreed to provide accomodation for the study's offices and senior staff in Navrongo, the District Capital. A further planning visit was made to Navrongo in July 1988, and the Study Director, Dr. David Ross, and Statistician, Nicola Dollimore arrived in Navrongo to start the fieldwork at the end of November 1988. They were soon joined by a Nutrition Technician, Mr. Kwabena Badu, who had been seconded to the study by the Department of Community Health of UST. Together, they sorted out the logistical issues, and started Mapping out the study area. Dr. Fred Binka, an Epidemiologist of the Ministry of Health of Ghana, who was on secondment to Noguchi Memorial Institute for Medical Research, was again seconded to the study a few months later with the responsibility of Coordinating Field Work. He came along with his assistant Mr. Owusu-Agyei, a biologist who had just completed national service at Nogichi Memorial Institute. Together with other Pioneers, the study began in March 1989.
The study officially ended in December 1991, after which it was taken over by the Ministry of Health with the name, Navrongo Health Research Centre, and Dr. Fred Binka was appointed the Director of the Centre. Hence the birth of Navrongo Health Research Centre (NHRC).
This study aims to establish whether or not, regular supplementation of young children who live in a rural area of Ghana where xerophthalmia exist, leads to a significant reduction in their mortality rate. The trial aims to overcome the main criticisms of the Indonesian trial by using a double-blind, randomized controlled trial design, with each child followed up to 24 months.
The design was a randomized double blind placebo controlled trial conducted over one year for the health study and two years for the survival study. Repeat dosing was done at 4-monthly intervals.
The study did not find any impact on the incidence of illness, but found a significant reduction in the severity of illness in children receiving vitamin A, especially for diarrhoeal diseases, but also for respiratory infections and measles. It also demonstrated that Vitamin A substantially reduced the burden on health services, both in terms of out patient and inpatient numbers. These are very important findings indeed, and provide an insight into the possible mechanisms through which Vitamin A works. It suggests that the impact on morbidity might be mediated through a reduction in the severity of illnesses.
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