Effect of daily low dose of vitamin A compared with single high dose on morbidity and mortality of hospitalized mainly malnourished children in senegal: a randomized controlled clinical trial.
BACKGROUND
In vitamin A-deficient populations, children hospitalized with infections and/or malnutrition are at particular risk of developing severe vitamin A (VA) deficiency. High-dose VA supplements are recommended as part of the treatment but results on its effect on recovery from morbidity and on prevention from nosocomial morbidity are conflicting.


OBJECTIVE
We aimed to assess the effect of a single high dose and daily low dose of VA on hospitalized malnourished children's morbidity.


METHODS
We carried out a double-blind, randomized trial in 604 and 610 Senegalese hospitalized children. The first mentioned batch received a high-dose VA supplement (200,000 IU) on admission, the second a daily low-dose VA supplement (5000 IU per day) during hospitalization. Children were followed up until discharged. Data on all-cause morbidity were collected daily.


RESULTS
Survival analysis showed that the incidence of respiratory disease was significantly lower in the low-dose group than in the high-dose group, hazard ratios (HR): 0.26, 95% CI: 0.07-0.92. The duration of respiratory infection was also significantly lower in the low-dose group than in the high-dose group (HR of cure: 1.41, 95% CI: 1.05-1.89). Duration and incidence of diarrhoea were not significantly different between treatment groups. In children with oedema on admission, mortality was significantly lower in the low-dose group (Adjusted odds ratio: 0.21; 95% CI: 0.05-0.99).


CONCLUSIONS
Daily low dose of VA compared with single high dose significantly reduced duration and incidence of respiratory infection but not of diarrhoea in hospitalized children.
Donnen
P
P
Department of Epidemiology and Preventive Medicine, Université Libre de Bruxelles, School of Public Health, Brussels, Belgium. pdonnen@ulb.ac.be
Sylla
A
A
Dramaix
M
M
Sall
G
G
Kuakuvi
N
N
Hennart
P
P
D000293:Adolescent; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D002675:Child, Preschool; D016001:Confidence Intervals; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004487:Edema / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009017:Morbidity; D016017:Odds Ratio; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D012675:Senegal; D016019:Survival Analysis; D014801:Vitamin A / Q000008:administration & dosage*; D014802:Vitamin A Deficiency / Q000150:complications / Q000188:drug therapy / Q000401:mortality
D014801:Vitamin A