Reduced mortality among children in Southern India receiving a small weekly dose of vitamin A

Article Abstract:

Throughout the world an estimated 40 million children are believed to be suffering from chronic vitamin A deficiency. A previous study documented the effect of a vitamin A deficiency in Indonesia, where it was found that supplementation with this vitamin was able to reduce the death rate of small children and infants by 34 percent. Nearly half of the world's population of children with vitamin A deficiency live in India. The present study examines the effect of giving vitamin A to preschool aged children of the Trichy district of Tamil Nadu, a southern Indian region known to have a high rate of vitamin A deficiency and malnutrition. A group of 15,419 children were given weekly doses of 8,333 International Units (IU) of vitamin A and 20 milligrams of vitamin E, or else vitamin E alone (as a control group). At the outset of the experiment, finger-stick samples of blood were taken, as were measurements of height and weight. A medical history was obtained from each child, who then received a medical examination. The doses of vitamins were given by staff directly into the children's mouths to assure compliance. Nearly 42 percent of the children received all doses, and more than 90 percent of the children received at least 70 percent of the supplementation. During the year of the experiment the number of deaths occurring in both the vitamin A and control group were collected. There were 125 deaths, of which only 8 were accidental. The death rate in the treated group was half of that of the control group, with most of the difference occurring among children who were under 3 years of age. Other symptoms of vitamin A deficiency, such as diarrhea, convulsions and infection-related conditions (e.g., morbidity from measles), were also significantly reduced among the children treated with vitamin A. The experiment shows that mortality due to chronic vitamin A deficiency mortality can be reduced by 54 percent in children by administration of a vitamin A supplement at a level that be provided by an adequate diet. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention

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Vitamin A supplements - too good not to be true

Article Abstract:

When children who are malnourished and vitamin deficient are exposed to infectious diseases, the rates of death (mortality) and complications (morbidity) markedly escalate. Often the cause of death in these children is diarrhea or infections of the lungs and bronchi. Studies of the effects of vitamin and mineral deficiency on mortality in a population of Indonesian children resulted in a therapeutic approach of providing protein-energy nutrition. However, these interventions have not brought the reduction in mortality that was envisioned. Some recent studies have suggested that public health strategies should concentrate on reducing the level of infection rather than improving the level of nutrition. An alternate approach is to provide the micronutrients such as iron or vitamin A. An article in the October 4, 1990 issue of The New England Journal of Medicine reports on the value of supplemental vitamin A given to children living in a region of southern India. This prospective, large-scale study followed the reduction in infant mortality that resulted from a year-long supplementation of vitamin A given directly to the children to assure compliance. This simple, inexpensive supplementation resulted in a highly significant reduction of death and morbidity associated with infections among children with chronic malnutrition. The major effect was on diarrhea and infection-related inflammation of the membranes which surround the brain and spinal cord (meningitis). Vitamin A deficiency, particularly in the presence of protein malnutrition, can lead to increased deaths of viral conditions such as measles. The annual cost of providing a child with vitamin A supplementation ranges between $1.64 and $2.20 per year, but even this small cost may be beyond the resources of some developing countries. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, editorial

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Diarrhea, respiratory infections, and growth are not affected by a weekly low-dose vitamin A supplement: a masked, controlled field trial in children in southern India

Article Abstract:

Vitamin A plays an essential role in the normal growth and development of the human body. Vitamin A deficiency is an important cause of blindness and stunted growth in children living in developing countries. Several studies have been performed to determine if vitamin A supplements can reduce morbidity and mortality from respiratory infections and diarrhea in children in underdeveloped countries. While one of these studies reported that vitamin A supplements reduce the risk of respiratory infections and diarrhea, four other studies reported that vitamin A supplements do not reduce morbidity from these conditions. In an attempt to clarify this issue, the effect of weekly low-dose vitamin A supplements on morbidity and mortality from respiratory infections and diarrhea was evaluated in 15,419 children living in southern India. Half of the children received weekly doses of vitamin A (2.5 milligrams) and vitamin E (20 milligrams) and the other half received vitamin E only. During the 52-week study period, episodes of diarrhea and respiratory infections were recorded and growth was measured. At the beginning of the study, 11 percent of the children were diagnosed with xerophthalmia (dry eye membranes) and 72 percent were malnourished. The results indicate that weekly vitamin A supplements neither reduced the incidence or severity of respiratory infections and diarrhea nor influenced growth. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Physiological aspects, Respiratory tract infections, Growth, Growth (Physiology), Dietary supplements, Nutritional aspects, Diarrhea in children, Childhood diarrhea, Vitamin A in human nutrition

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