Flashback: Studies show benefit for children with Measles receiving vitamin A
Posted by kandylini on June 13, 2008
Something you don’t hear about from most pediatricians. They probably don’t even know about this information.
It’s best to give kids high-vitamin cod liver oil daily to bolster their health. The oil should have a 1 to 10 ratio of vitamin D to A. Children from 3 months to 12 years old should get about 5,000 i.u. of vitamin A daily.
“A randomized, controlled trial of vitamin A in children with severe measles.”
Department of Paediatrics and Child Health, University of Cape Town, South Africa.
BACKGROUND. Measles kills about 2 million children annually, and there is no specific therapy for the disease. It has been suggested that vitamin A may be of benefit in the treatment of measles.
METHODS. We conducted a randomized, double-blind trial involving 189 children who were hospitalized at a regional center in South Africa because of measles complicated by pneumonia, diarrhea, or croup. The children (median age, 10 months) were assigned to receive either vitamin A (total dose, 400,000 IU of retinyl palmitate, given orally; n = 92) or placebo (n = 97), beginning within five days of the onset of the rash. At base line, the characteristics of the two groups were similar.
RESULTS. Although clinically apparent vitamin A deficiency is rare in this population, the children’s serum retinol levels were markedly depressed (mean [+/- SEM], 0.405 +/- 0.021 mumols per liter [11.6 +/- 0.6 micrograms per deciliter]), and 92 percent of them had hyporetinemia (serum retinol level less than 0.7 mumols per liter [20 micrograms per deciliter]). Serum concentrations of retinol-binding protein (mean, 30.1 +/- 2.0 mg per liter) and albumin (mean, 33.4 +/- 0.5 g per liter) were also low. As compared with the placebo group, the children who received vitamin A recovered more rapidly from pneumonia (mean, 6.3 vs. 12.4 days, respectively; P less than 0.001) and diarrhea (mean, 5.6 vs. 8.5 days; P less than 0.001), had less croup (13 vs. 27 cases; P = 0.03), and spent fewer days in the hospital (mean, 10.6 vs. 14.8 days; P = 0.01). Of the 12 children who died, 10 were among those given placebo (P = 0.05). For the group treated with vitamin A, the risk of death or a major complication during the hospital stay was half that of the control group (relative risk, 0.51; 95 percent confidence interval, 0.35 to 0.74).
CONCLUSIONS. Treatment with vitamin A reduces morbidity and mortality in measles, and all children with severe measles should be given vitamin A supplements, whether or not they are thought to have a nutritional deficiency.
PMID: 2194128 [PubMed - indexed for MEDLINE]
******************************************************************************
“Vitamin A for treating measles in children“
Huiming Y, Chaomin W, Meng M
Summary
Two megadoses of vitamin A lowers the risk of death from measles in hospitalized children under the age of two years, but not in all children with measles
Measles is caused by a virus and results in a high fever and rash. Possible complications include pneumonia. Measles is a major cause of death in children in developing countries and is particularly dangerous for children with a vitamin A deficiency. This review found that there was no significant reduction in mortality in children receiving vitamin when all the studies were pooled together. However, vitamin A megadoses (200,000 international units on each of two days) lowered the number of deaths from measles in hospitalized children who were under the age of two years. A single dose did not lower death rates.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 2, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Huiming Y, Chaomin W, Meng M. Vitamin A for treating measles in children. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD001479. DOI: 10.1002/14651858.CD001479.pub3
This version first published online: April 23. 2001
Date of last substantive update: July 01. 2005
Abstract
Background
Measles is a major cause of childhood morbidity and mortality. Vitamin A deficiency is a recognized risk factor for severe measles infections. The World Health Organization (WHO) recommends administration of an oral dose of vitamin A (200,000 international units (IU), or 100,000 IU in infants) each day for two days to children with measles when they live in areas where vitamin A deficiency may be present.
Objectives
To determine whether vitamin A therapy, commenced after measles has been diagnosed, is beneficial in preventing mortality, pneumonia and other secondary complications in children.
Search strategy
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to March 2005), EMBASE (1980 to December 2004) and looked for unpublished studies.
Selection criteria
Only randomized controlled trials in which children with measles were given vitamin A or placebo along with standard treatment were considered.
Data collection and analysis
Studies were assessed independently by two authors. The analysis of dichotomous outcomes was done using the StatXact software and results expressed as relative risk (RR) with 95% confidence interval (CI). Subgroup analyses were carried out for dose, formulation, age, hospitalization and pneumonia-specific mortality. Weighted mean differences (WMD) with 95% CI were calculated for continuous outcomes.
Main results
There was no significant reduction in the risk of mortality in the vitamin A group when all the studies were pooled using the random-effects model (RR 0.70; 95% CI 0.42 to 1.15). Using two doses of vitamin A (200,000 IU) on consecutive days was associated with a reduction in the risk of mortality in children under the age of two years (RR 0.18; 95% CI 0.03 to 0.61) and a reduction in the risk of pneumonia-specific mortality (RR 0.33; 95% CI 0.08 to 0.92). There was no evidence that vitamin A in a single dose was associated with a reduced risk of mortality among children with measles. There was a reduction in the incidence of croup (RR 0.53; 95% CI 0.29 to 0.89) but no significant reduction in the incidence of pneumonia (RR 0.92; 95% CI 0.69 to 1.22) or diarrhoea (RR 0.80; 95% CI 0.27 to 2.34) with two doses.
Authors’ conclusions
Although we found no overall significant reduction in mortality with vitamin A therapy for children with measles there was evidence that two doses were associated with a reduced risk of mortality and pneumonia-specific mortality in children under the age of two years. There were no trials that directly compared a single dose with two doses.
