title: Effect of vitamin A supplementation on cause-specific mortality in women of reproductive age in Ghana: a secondary analysis from the ObaapaVitA trial.
abstract: OBJECTIVE
  To determine the effect of weekly low-dose vitamin A supplementation on cause-specific mortality in women of reproductive age in Ghana.
  
  
  METHODS
  A cluster-randomized, triple-blind, placebo-controlled trial was conducted in seven districts of the Brong Ahafo region of Ghana. Women aged 15-45 years who were capable of giving informed consent and intended to live in the trial area for at least 3 months were enrolled and randomly assigned, according to their cluster of residence, to receive oral vitamin A (7500 μg) or placebo once a week. Randomization was blocked, with two clusters in each fieldwork area allocated to vitamin A and two to placebo. Every 4 weeks, fieldworkers distributed capsules and collected data during home visits. Verbal autopsies were conducted by field supervisors and reviewed by physicians, who assigned a cause of death. Cause-specific mortality rates in both arms were compared by means of random-effects Poisson regression models to allow for the cluster randomization. Analysis was by intention-to-treat, based on cluster of residence, with women eligible for inclusion once they had consistently received the supplement or placebo capsules for 6 months.
  
  
  RESULTS
  The analysis was based on 581 870 woman-years and 2624 deaths. Cause-specific mortality rates were found to be similar in the two study arms.
  
  
  CONCLUSIONS
  Low-dose vitamin A supplements administered weekly are of no benefit in programmes to reduce mortality in women of childbearing age.
authors: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, England. lisa.hurt@lshtm.ac.uk
authors: Lisa
authors: L
authors: Hurt
authors: Augustinus
authors: A
authors: ten Asbroek
authors: Seeba
authors: S
authors: Amenga-Etego
authors: Charles
authors: C
authors: Zandoh
authors: Samuel
authors: S
authors: Danso
authors: Karen
authors: K
authors: Edmond
authors: Chris
authors: C
authors: Hurt
authors: Charlotte
authors: C
authors: Tawiah
authors: Zelee
authors: Z
authors: Hill
authors: Justin
authors: J
authors: Fenty
authors: Seth
authors: S
authors: Owusu-Agyei
authors: Oona M
authors: OM
authors: Campbell
authors: Betty R
authors: BR
authors: Kirkwood
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D019587:Dietary Supplements; D005260:Female; D005869:Ghana; D006801:Humans; D008875:Middle Aged; D016012:Poisson Distribution; D014801:Vitamin A / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014815:Vitamins; D014801:Vitamin A
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