Impact of massive dose of vitamin A given to preschool children with acute diarrhoea on subsequent respiratory and diarrhoeal morbidity.
BMJ 1994 Nov 26;309(6966):1404-7 (ISSN: 0959-8138)
Bhandari N; Bhan MK; Sazawal S Department of Paediatrics, All India Institute of Medical Sciences, New Delhi.
OBJECTIVE--To assess the impact of vitamin A supplementation on morbidity
from acute respiratory tract infections and diarrhoea. DESIGN--Double
blind randomised placebo controlled field trial. SETTING--An urban slum
area in New Delhi, India. SUBJECTS--900 children aged 12-60 months attending
a local health facility for acute diarrhoea of less than seven days' duration
randomly allocated to receive vitamin A 200,000 IU or placebo. MAIN OUTCOME
MEASURES--Incidence and prevalence of acute lower respiratory tract infections
and diarrhoea during the 90 days after termination of the enrolment diarrhoeal
episode measured by twice weekly household surveillance. RESULTS--The
incidence (relative risk 1.07; 95% confidence interval 0.92 to 1.26) and
average number of days spent with acute lower respiratory tract infections
were similar in the vitamin A supplementation and placebo groups. Among
children aged 23 months or less there was a significant reduction in the
incidence of measles (relative risk 0.06; 95% confidence interval 0.01
to 0.48). The incidence of diarrhoea was also similar (relative risk 0.95;
0.86 to 1.05) in the two groups. There was a 36% reduction in the mean
daily prevalence of diarrhoea associated with fever in the vitamin A supplemented
children older than 23 months. CONCLUSIONS--Results were consistent with
a lack of impact on acute lower respiratory tract related mortality after
vitamin A supplementation noted in other trials and a possible reduction
in the severity of diarrhoea.
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