Vitamin A levels and mortality among hospitalized measles patients, Kinshasa, Zaire.
Treatment with high dose vitamin A has recently been recommended for children with measles in communities where vitamin A deficiency is a recognized problem. However, the relationship between vitamin A and measles mortality has not been clearly established. We studied serum vitamin A levels in 283 children less than or equal to 5 years of age admitted to Mama Yemo and Kalembe Lembe Hospitals in Kinshasa, Zaire, between January and March, 1987. Vitamin A levels were determined by high performance liquid chromatography. Vitamin A levels ranged from less than 5 to 63 micrograms/dl (median, 8). The overall case-fatality rate was 26 per cent. On univariate analysis, age less than 24 months, pneumonia on admission, lymphopenia (less than 2000/mm3), and lower vitamin A levels were associated with death during hospitalization. In a multivariate logistic regression model, a vitamin A level less than 5 micrograms/dl was associated with fatal outcome for children younger than 24 months old (relative risk = 2.9, 95 per cent CI 1.3, 6.8), but not for older children. Further studies are needed to determine whether low vitamin A levels predispose children to severe measles and the role of vitamin A supplements in the prevention of measles mortality.
Markowitz
L E
LE
Nzilambi
N
N
Driskell
W J
WJ
Sension
M G
MG
Rovira
E Z
EZ
Nieburg
P
P
Ryder
R W
RW
D002675:Child, Preschool; D015023:Democratic Republic of the Congo; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000188:drug therapy / Q000401:mortality*; D014801:Vitamin A / Q000097:blood* / Q000627:therapeutic use
D014801:Vitamin A