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Vitamin A supplementation had no overall effect on child mortality
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High-dose vitamin A supplementation given to children between the ages of 6 to 23 months at routine vaccination contacts in Guinea-Bissau had no overall effect on mortality, according to recent data published in Pediatrics.
Ane B. Fisker, MD, PhD, of the Bandim Health Project, in New Guinea-Bassau, and colleagues conducted a randomized double-blind trial in response to WHO’s recommendation that high-dose vitamin A supplementation could reduce mortality by 24%. It was the first randomized controlled trial to assess the policy’s effect on overall mortality.
“In contrast to current assumptions, we found no overall effect of vitamin A supplementation,” the study’s researchers wrote. “Given the lack of an overall effect, more randomized trials are warranted to justify the WHO policy.”
The study included 7,587 children aged 6 to 23 months and recorded 80 nonaccidental deaths within 6 months. Thirty-eight of these were participants assigned vitamin A supplementation while 42 were assigned placebo, resulting in a mortality rate ratio of 0.91 (95% CI, 0.59–1.41).
There was an observed difference between boys and girls; boys assigned vitamin A supplementation had a higher mortality rate ratio of 1.92 (.98–3.75), compared with the .45 (.24–.87) mortality rate ratio among girls assigned the same treatment.
“Although our study concurs with previous studies showing a beneficial effect in girls of repeated doses of vitamin A, we have not previously observed that a negative effect should be boosted in boys receiving repeated doses,” the researchers wrote. “In light of the very low mortality in placebo boys who have previously received vitamin A supplementation, we cannot rule out that it could be a chance finding.”
Participants’ supplementations were assigned alongside live measles vaccines (42%), inactivated diphtheria-tetanus-pertussis containing vaccines (29%), and both live and inactivated vaccines (21%); however the effect of vitamin A supplementation did not differ by vaccine group.
“We need to examine whether the beneficial effect of VAS has waned over time and to identify when vitamin A supplementation is beneficial. Importantly, we need to ensure that we do not give vitamin A supplementation when it might be harmful,” the researchers concluded.
Disclosure: The authors report no relevant financial disclosures.
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