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Effect of daily low dose of vitamin A compared with single high dose on morbidity and mortality of hospitalized mainly malnourished children in senegal: a randomized controlled clinical trial

European Journal of Clinical Nutrition volume 61, pages 1393–1399 (2007)Cite this article

Abstract

Background:

In vitamin A-deficient populations, children hospitalized with infections and/or malnutrition are at particular risk of developing severe vitamin A (VA) deficiency. High-dose VA supplements are recommended as part of the treatment but results on its effect on recovery from morbidity and on prevention from nosocomial morbidity are conflicting.

Objective:

We aimed to assess the effect of a single high dose and daily low dose of VA on hospitalized malnourished children's morbidity.

Design:

We carried out a double-blind, randomized trial in 604 and 610 Senegalese hospitalized children. The first mentioned batch received a high-dose VA supplement (200 000 IU) on admission, the second a daily low-dose VA supplement (5000 IU per day) during hospitalization. Children were followed up until discharged. Data on all-cause morbidity were collected daily.

Results:

Survival analysis showed that the incidence of respiratory disease was significantly lower in the low-dose group than in the high-dose group, hazard ratios (HR): 0.26, 95% CI: 0.07–0.92. The duration of respiratory infection was also significantly lower in the low-dose group than in the high-dose group (HR of cure: 1.41, 95% CI: 1.05–1.89). Duration and incidence of diarrhoea were not significantly different between treatment groups. In children with oedema on admission, mortality was significantly lower in the low-dose group (Adjusted odds ratio: 0.21; 95% CI: 0.05–0.99).

Conclusions:

Daily low dose of VA compared with single high dose significantly reduced duration and incidence of respiratory infection but not of diarrhoea in hospitalized children.

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Acknowledgements

We thank all the participating children and their parents for their collaboration as well as the staff of the Pediatric Unit of the Hôpital Le Dantec. We thank Lynda Benammar for preparing vitamin A solutions. We thank Jean-Marie Boeynaems for retinol analyses.

Supported in part by a grant from the Fonds de la Recherche Scientifique Médicale (contract 1.5118.98F) and the David and Alice Van Buuren Foundation.

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Authors and Affiliations

  1. Department of Epidemiology and Preventive Medicine, Université Libre de Bruxelles, School of Public Health, Brussels, Belgium

    P Donnen & P Hennart

  2. Centre Scientifique et Médical de l'Université Libre de Bruxelles pour ses Activités de Coopération (CEMUBAC), Brussels, Belgium

    P Donnen & P Hennart

  3. Hôpital Le Dantec, Dakar, Sénégal

    A Sylla, G Sall & N Kuakuvi

  4. Laboratory of Medical Statistics, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium

    M Dramaix

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  1. P Donnen
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  2. A Sylla
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  3. M Dramaix
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  4. G Sall
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  5. N Kuakuvi
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  6. P Hennart
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Corresponding author

Correspondence to P Donnen.

Additional information

Contributors: All authors designed the paper and revised the manuscript. AS, GS and NK were responsible for data collection in Senegal. PD and MD were responsible for data management, statistical analysis and preparation of the paper. PH provided overall supervision of the analysis and preparation of this report.

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Donnen, P., Sylla, A., Dramaix, M. et al. Effect of daily low dose of vitamin A compared with single high dose on morbidity and mortality of hospitalized mainly malnourished children in senegal: a randomized controlled clinical trial. Eur J Clin Nutr 61, 1393–1399 (2007). https://doi.org/10.1038/sj.ejcn.1602671

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