title: Integration of vitamin A supplementation with the Expanded Programme on Immunization: lack of impact on morbidity or infant growth.
abstract: Vitamin A deficiency is associated with increased morbidity and mortality from diarrheal disease, measles, and malaria. It has been proposed that vitamin A supplementation could be linked with childhood immunization programs to improve child health. We conducted a randomized, double-blind, placebo-controlled clinical trial to evaluate the impact of linking vitamin A supplementation with the Expanded Programme on Immunization on morbidity and child growth. In West Java, Indonesia, 467 six-week-old infants were randomized to receive 7.5 mg retinol equivalent (RE), 15 mg RE, or placebo with childhood immunization contacts at 6, 10, and 14 wks and 9 mo of age. Child growth was assessed through anthropometry, and morbidity histories were obtained. Vitamin A supplementation had no apparent impact upon linear or ponderal growth or infectious disease morbidity in the first 15 mo of age when integrated with the Expanded Programme on Immunization.
  
  
  CONCLUSIONS
  Although improving vitamin A nutriture is of general importance in reducing diarrheal and measles morbidity and mortality in developing countries, this clinical trial showed no apparent benefit of vitamin A capsules for infant health when given through childhood immunization programs.
authors.affiliation: Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. rdsemba@jhmi.edu
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: Z
authors.initials: Z
authors.lastname: Munasir
authors.forename: A
authors.initials: A
authors.lastname: Akib
authors.forename: G
authors.initials: G
authors.lastname: Melikian
authors.forename: D
authors.initials: D
authors.lastname: Permaesih
authors.lastname: Muherdiyantiningsih
authors.forename: S
authors.initials: S
authors.lastname: Marituti
authors.lastname: Muhilal
mesh_terms: D002657:Child Development; D002669:Child Welfare; D002675:Child, Preschool; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D008297:Male; D014801:Vitamin A / Q000008:administration & dosage*
chemical_list: D014801:Vitamin A