Effect Of Periodic Vitamin A Supplementation On Mortality And Morbidity Of Human Immunodeficiency Virus–Infected Children In Uganda: A Controlled Clinical Trial
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Date
2005
Journal Title
Journal ISSN
Volume Title
Publisher
Nutrition
Abstract
We investigated whether vitamin A supplementation would decrease mortality and morbidity rates in children infected with the human immunodeficiency virus (HIV).We conducted a randomized, double-blind, placebo-controlled clinical trial at Mulago Hospital, a large hospital that serves the urban and semiurban populations of Kampala, Uganda. One hundred eighty-one HIV-infected children were enrolled at 6 mo and randomized to receive vitamin A supplementation, 60 mg retinol equivalent, or placebo every 3 mo from ages 15 to 36 mo. Morbidity was assessed through a 7-d morbidity history every 3 mo, and vital events were measured. Children received daily trimethoprim-sulfamethoxazole prophylactic therapy.After age 15 mo, children were followed for a median of 17.8 mo (interquartile range = 11.1 to 21.0 mo). The trial was stopped when there was a new policy to implement a program of mass supplementation of vitamin A in the country. Mortality rates among 87 children in the vitamin A group and 94 children in the control group were 20.6% and 32.9%, respectively, yielding a relative risk of 0.54 (95% confidence interval, 0.30 to 0.98; P = 0.044) after adjusting for baseline weight-for-height Z score. Children who received vitamin A had lower modified point prevalences of persistent cough (odds ratio, 0.47; 95% confidence interval, 0.23 to 0.96; P = 0.038) and chronic diarrhea (odds ratio, 0.48; 95% confidence interval, 0.19 to 1.18; P = 0.11) and a shorter duration of ear discharge (P = 0.03). Vitamin A supplementation had no significant effect on modified point prevalences of fever, ear discharge, bloody stools, or hospitalizations.Vitamin A supplementation decreases mortality rate in HIV-infected children and should be considered in the care for these children in developing countries.
Description
Keywords
Children; Human immunodeficiency virus; Morbidity; Mortality; Retinol; Vitamin A deficiency
Citation
Semba, R. D., Ndugwa, C., Perry, R. T., Clark, T. D., Jackson, J. B., Melikian, G., ... & Mmiro, F. (2005). Effect of periodic vitamin A supplementation on mortality and morbidity of human immunodeficiency virus–infected children in Uganda: a controlled clinical trial. Nutrition, 21(1), 25-31. https://doi.org/10.1016/j.nut.2004.10.004