Vitamin A supplementation reduces measles morbidity in young African children: a randomized, placebo-controlled, double-blind trial.

Randomized, placebo-controlled, double-blind trial in 60 hospitalized African children aged 4 to 24 months with measles complicated by pneumonia and diarrhea in Durban, South Africa. The active vitamin A arm included 29 children.

Vitamin A was given as retinyl palmitate (Arovit Drops) by mouth in the WHO-recommended dose: 54.5 mg for children under 12 months and 109 mg for children 12 months or older. Doses were administered on admission, and again on days 2 and 8, compared with placebo plus standard therapy.

Vitamin A reduced measles-related morbidity and accelerated recovery. Complete clinical recovery within 7 days occurred in 28/29 (96%) with vitamin A versus 11/31 (65%) with placebo, P=0.002; day 8 IMS was 0.24±0.15 versus 1.37±0.40. At 6 weeks and 6 months, vitamin A was associated with fewer respiratory and pneumonia episodes, lower IMS scores, and greater weight gain, while diarrhea was not significantly improved. No deaths occurred in the vitamin A group versus 1 in placebo. These findings support vitamin A supplementation during acute measles.

Small single-center trial with only 29 children in the vitamin A arm, limiting precision and generalizability. Participants were hospitalized children with complicated measles in a low-socioeconomic setting, so results may not extend to milder cases or other populations. Some outcomes were descriptive and diarrhea benefit was not demonstrated.