Vitamin A supplementation and morbidity among preschool children in south India

Abstract

A randomized, double-blind, placebo-controlled trial was conducted in an ongoing Growth Monitoring Research project in TamilNadu, India, to assess the impact of high-dose vitamin A supplementation on morbidity among mildly to moderately malnourished children aged < 3 y. Every 4 mo, the treatment group received 60 mg vitamin A (200,000 IU) whereas the control group received a placebo. Cases of xerophthalmia and severe malnutrition were excluded. Anthropometric measurements and serum retinol determinations were made at baseline and at the end of 1 y. Morbidity data were collected by trained village-level workers throughout the study period by using the weekly recall method. The two groups had similar nutritional status, serum retinol concentrations, age-sex composition, and other sociodemographic indicators at baseline. The mean number of episodes per child-year was 2.62 +/- 2.95 and 2.56 +/- 2.5 for respiratory illness and 1.9 +/- 2.2 and 1.77 +/- 1.77 for diarrhea for the vitamin A (n = 309) and placebo (n = 274) groups, respectively. The differences in respiratory and diarrheal morbidity between the two groups were not statistically significant and these findings remained unaltered after multivariate analysis in which the effects of age, sex, socioeconomic status, sanitation, etc, were considered. These findings are similar to other recent findings and indicate that vitamin A supplementation does not reduce common morbidity in children with mild-to-moderate vitamin A deficiency in areas where access to health care and immunization are good.