title: Newborn vitamin A supplementation does not affect nasopharyngeal carriage of Streptococcus pneumoniae in Bangladeshi infants at age 3 months.
abstract: Nasopharyngeal (NP) carriage of S. pneumoniae (Spn) is a risk factor for pneumococcal disease and its transmission. We assessed the impact of vitamin A (VA) supplementation shortly after birth in reducing Spn colonization in early infancy in rural Bangladesh. We recruited 500 infants participating in a cluster-randomized trial that reported a 15% reduction in mortality following receipt of an oral dose of VA (52.25 μmol) compared to placebo. NP specimens were collected at the age of 3 mo to study the effect of VA on the prevalence of culture-confirmed Spn. Analyses were conducted by intention to treat. Spn carriage prevalence did not differ between VA and placebo recipients [OR = 0.83 (95% CI: 0.55-1.27); P = 0.390]. Spn carriage at the age of 3 mo was not lowered by VA given at birth. Results are similar to those from an Indian study in which impact on Spn carriage was assessed at the age of 4 mo [OR = 0.73 (95% CI: 0.48-1.10); P = 0.128]. The point estimate of the pooled effect size for the 2 studies is OR = 0.78 [(95% CI: 0.58-1.04); P = 0.095], which may imply a modest impact on carriage. If so, then the evidence thus far would suggest that Spn carriage reduction is unlikely to be a primary ancillary benefit of newborn VA supplementation.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. ccoles@jhsph.edu
authors.forename: Christian L
authors.initials: CL
authors.lastname: Coles
authors.forename: Alain
authors.initials: A
authors.lastname: Labrique
authors.forename: Samir K
authors.initials: SK
authors.lastname: Saha
authors.forename: Hasmot
authors.initials: H
authors.lastname: Ali
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Emran
authors.forename: Mahbubur
authors.initials: M
authors.lastname: Rashid
authors.forename: Parul
authors.initials: P
authors.lastname: Christian
authors.forename: Keith P
authors.initials: KP
authors.lastname: West
authors.forename: Rolf
authors.initials: R
authors.lastname: Klemm
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D003906:Developing Countries; D019587:Dietary Supplements; D004311:Double-Blind Method; D024882:Drug Resistance, Viral; D057239:Early Termination of Clinical Trials; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009305:Nasopharynx / Q000821:virology*; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control; D015995:Prevalence; D012423:Rural Health; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D014801:Vitamin A / Q000627:therapeutic use*
chemical_list: D014801:Vitamin A