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Vitamin A related mortality study in patients with eodema

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 2 replies. You can also reply via email – be sure to leave the subject unchanged.

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Tarig Abdulgadir

CMAM Specialist / UNICEF

Normal user

22 Jun 2009, 16:54

Any one can help in guiding me where i could find the study that shown increased mortality rate among children with severe acute malnutrition with edema after receiving vitamin A? Any clue about the mechanism of these Vit A toxicity?

André BRIEND

Frequent user

24 Jun 2009, 12:52

Donnen P, Sylla A, Dramaix M, Sall G, Kuakuvi N, Hennart P. 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. 2007 Dec;61(12):1393-9.

Department of Epidemiology and Preventive Medicine, Université Libre de Bruxelles, School of Public Health, Brussels, Belgium. pdonnen@ulb.ac.be

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.

Note: The low dose group received amount of vitamin A equivalent to what is in F-100/RUTF.

Tarig Abdulgadir

CMAM Specialist / UNICEF

Normal user

29 Jun 2009, 16:27

Thank you a lot for these information

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