title: Child morbidity and mortality following vitamin A supplementation in Ghana: time since dosing, number of doses, and time of year.
abstract: OBJECTIVE
  The impact of large-dose vitamin A supplementation given at intervals of 4 months on child mortality and morbidity was examined according to the time interval since dosing, number of doses received previously, and time of year.
  
  
  METHODS
  Two double-blind, randomized, placebo-controlled trials of large doses of vitamin A administered at intervals of 4 months were conducted in adjacent populations in northern Ghana.
  
  
  RESULTS
  While vitamin A supplementation significantly reduced the overall incidence of severe illnesses (especially diarrhea with dehydration), clinic attendances, hospital admissions, and mortality, there was no evidence that the impact of each dose of vitamin A was related to the number of doses the child had received previously. There was no evidence that the effectiveness of the supplement waned over the 3 to 5 months between doses. The impact on mortality did not differ significantly by the month in which the supplement had been given.
  
  
  CONCLUSIONS
  In the study population, there was no evidence that an interval between doses of less than 4 months would have had a greater impact on severe morbidity or mortality, and the effectiveness of supplementation did not vary by time of year.
authors.affiliation: Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, England.
authors.forename: D A
authors.initials: DA
authors.lastname: Ross
authors.forename: B R
authors.initials: BR
authors.lastname: Kirkwood
authors.forename: F N
authors.initials: FN
authors.lastname: Binka
authors.forename: P
authors.initials: P
authors.lastname: Arthur
authors.forename: N
authors.initials: N
authors.lastname: Dollimore
authors.forename: S S
authors.initials: SS
authors.lastname: Morris
authors.forename: R P
authors.initials: RP
authors.lastname: Shier
authors.forename: J O
authors.initials: JO
authors.lastname: Gyapong
authors.forename: P G
authors.initials: PG
authors.lastname: Smith
mesh_terms: D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D005869:Ghana / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality; D012306:Risk; D013997:Time Factors; D014801:Vitamin A / Q000627:therapeutic use*; D014802:Vitamin A Deficiency / Q000150:complications* / Q000188:drug therapy*
chemical_list: D014801:Vitamin A