Red palm oil as a source of vitamin A for mothers and children: impact of a pilot project in Burkina Faso.
To demonstrate the effectiveness of the commercial introduction of red palm oil (RPO) as a source of vitamin A (VA) for mothers and children in a non-consuming area, as a dietary diversification strategy. A pre-post intervention design (no control area) was used to assess changes in VA intake and status over a 24-month pilot project. The pilot project involved RPO promotion in 10 villages and an urban area in east-central Burkina Faso, targeting approximately 10 000 women and children aged <5 years. A random sample of 210 mother-child (12-36-months-old) pairs was selected in seven out of the 11 pilot sites for the evaluation. After 24 months, RPO was reportedly consumed by nearly 45% of mothers and children in the previous week. VA intake increased from 235+/-23 microg retinol activity equivalents (RAE) to 655+/-144 microg RAE in mothers (41 to 120% of safe intake level), and from 164+/-14 microg RAE to 514+/-77 microg RAE in children (36 to 97%). Rates of serum retinol <0.70 micromol l(-1) decreased from 61.8+/-8.0% to 28.2+/-11.0% in mothers, and from 84.5+/-6.4% to 66.9+/-11.2% in children. Those with a lower initial concentration of serum retinol showed a higher serum retinol response adjusted for VA intake. Commercial distribution of RPO was effective in reducing VA deficiency in the pilot sites. While it is promising as part of a national strategy, additional public health and food-based measures are needed to control VA malnutrition, which remained high in the RPO project area.