Effect of vitamin A supplementation in women of reproductive age on cause-specific early and late infant mortality in rural Ghana: ObaapaVitA double-blind, cluster-randomised, placebo-controlled trial.
Objectives To assess the effect of vitamin A supplementation in women of reproductive age in Ghana on cause- and age-specific infant mortality. In addition, because of recently published studies from Guinea Bissau, effects on infant mortality by sex and season were assessed.  Design Double-blind, cluster-randomised, placebo-controlled trial.  Setting 7 contiguous districts in the Brong Ahafo region of Ghana.  Participants All women of reproductive age (15-45 years) resident in the study area randomised by cluster of residence. All live born infants from 1 June 2003 to 30 September 2008 followed up through 4-weekly home visits.  Intervention Weekly low-dose (25 000 IU) vitamin A.  Main outcome measures Early infant mortality (1-5 months); late infant mortality (6-11 months); infection-specific infant mortality (0-11 months).  Results 1086 clusters, 62 662 live births, 52 574 infant-years and 3268 deaths yielded HRs (95% CIs) comparing weekly vitamin A with placebo: 1.04 (0.88 to 1.05) early infant mortality; 0.99 (0.84 to 1.18) late infant mortality; 1.03 (0.92 to 1.16) infection-specific infant mortality. There was no evidence of modification of the effect of vitamin A supplementation on infant mortality by sex (Wald statistic =0.07, p=0.80) or season (Wald statistic =0.03, p=0.86).  Conclusions This is the largest analysis of cause of infant deaths from Africa to date. Weekly vitamin A supplementation in women of reproductive age has no beneficial or deleterious effect on the causes of infant death to age 6 or 12 months in rural Ghana.  Trial registration number http://ClinicalTrials.gov: NCT00211341.
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Karen
K
Edmond
Lisa
L
Hurt
Justin
J
Fenty
Seeba
S
Amenga-Etego
Charles
C
Zandoh
Chris
C
Hurt
Samuel
S
Danso
Charlotte
C
Tawiah
Zelee
Z
Hill
Augustinus H A
AH
Ten Asbroek
Seth
S
Owusu-Agyei
Oona
O
Campbell
Betty R
BR
Kirkwood