Vitamin A supplementation reduces measles morbidity in young African children: a randomized, placebo-controlled, double-blind trial.
What this study found
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.
- Study & population
- 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.
- Intervention
- 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.
- Key limitation
- Small single-center trial with only 29 children in the vitamin A arm, limiting precision and generalizability.
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Open PDFOriginal abstract
The effects of vitamin A supplementation on measles morbidity are unclear. Sixty hospitalized children aged 4-24 mo with complicated measles received a World Health Organization--(WHO) recommended dose of vitamin A or placebo. The two groups were comparable in known covariants of measles severity: weight-for-age percentiles, overcrowding, rash, total lymphocytes, and serum concentrations of zinc, albumin, prealbumin, retinol-binding protein, and vitamins A and E. Ninety percent of the patients had hyporetinemia. Integrated morbidity scores, determined by severity of condition (eg, diarrhoea, herpes, and respiratory-tract infection) were assigned on day 8 and 6 wk and 6 mo; these were reduced by 82%, 61%, and 85%, respectively, in the supplemented group, which was mainly due to reduced respiratory-tract infection. There was one death in the placebo group. At 6 wk weight gain was significant in the supplemented group. Despite the selected sample, attention to multiple covariates enhances the validity of the data obtained and supports the current WHO recommendations for vitamin A supplementation during measles.