title: Randomised study of effect of different doses of vitamin A on childhood morbidity and mortality.
abstract: OBJECTIVE
  To determine whether the dose of vitamin A currently recommended by the World Health Organization or half this dose gives better protection against childhood morbidity and mortality.
  
  
  METHODS
  Randomised study.
  
  
  METHODS
  A combined oral polio vaccine and vitamin A supplementation campaign in Guinea-Bissau, Africa.
  
  
  METHODS
  4983 children aged 6 months to 5 years.
  
  
  METHODS
  One of two doses of vitamin A (recommended and half); oral polio vaccine.
  
  
  METHODS
  Mortality and morbidity at six and nine months.
  
  
  RESULTS
  Mortality was lower in the children who took half the recommended dose of vitamin A compared with the full dose at both six months (mortality rate ratio 0.69, 95% confidence interval 0.36 to 1.35) and nine months (0.62, 0.36 to 1.06) of follow-up. There was a significant interaction between sex and dose, the lower dose being associated with significantly reduced mortality in girls (0.19, 0.06 to 0.66) but not in boys (1.98, 0.74 to 5.29). The lower dose of vitamin A was consistently associated with lower hospital case fatality in girls (0.19, 0.02 to 1.45). Paradoxically, in children aged 6-18 months, the low dose was associated with slightly higher morbidity.
  
  
  CONCLUSIONS
  Half the dose of vitamin A currently recommended by WHO may provide equally good or better protection against mortality but not against morbidity.
authors.affiliation: Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen, Denmark. cb@ssi.dk
authors.forename: Christine Stabell
authors.initials: CS
authors.lastname: Benn
authors.forename: Cesario
authors.initials: C
authors.lastname: Martins
authors.forename: Amabelia
authors.initials: A
authors.lastname: Rodrigues
authors.forename: Henrik
authors.initials: H
authors.lastname: Jensen
authors.forename: Ida Maria
authors.initials: IM
authors.lastname: Lisse
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
mesh_terms: D000328:Adult; D046688:Child Mortality; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008423:Maternal Age; D009017:Morbidity; D011055:Poliovirus Vaccine, Oral; D014801:Vitamin A / Q000008:administration & dosage*
chemical_list: D011055:Poliovirus Vaccine, Oral; D014801:Vitamin A