Journal article
Effect of periodic vitamin A supplementation on mortality and morbidity of human immunodeficiency virus–infected children in Uganda: A controlled clinical trial
Nutrition (Burbank, Los Angeles County, Calif.), Vol.21(1), pp.25-31
2005
DOI: 10.1016/j.nut.2004.10.004
PMID: 15661475
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.
Details
- Title: Subtitle
- Effect of periodic vitamin A supplementation on mortality and morbidity of human immunodeficiency virus–infected children in Uganda: A controlled clinical trial
- Creators
- Richard D Semba - Department of Ophthalmology Johns Hopkins School of Medicine, Baltimore, MD, USAChristopher Ndugwa - Departments of Paediatrics and Child Health Makerere University School of Medicine, Kampala, UgandaRobert T Perry - Department of Ophthalmology Johns Hopkins School of Medicine, Baltimore, MD, USATamara D Clark - Department of Ophthalmology Johns Hopkins School of Medicine, Baltimore, MD, USAJ. Brooks Jackson - Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USAGeorge Melikian - Department of Ophthalmology Johns Hopkins School of Medicine, Baltimore, MD, USAJames Tielsch - Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USAFrancis Mmiro - Departments of Obstetrics and Gynaecology, Makerere University School of Medicine, Kampala, Uganda
- Resource Type
- Journal article
- Publication Details
- Nutrition (Burbank, Los Angeles County, Calif.), Vol.21(1), pp.25-31
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.nut.2004.10.004
- PMID
- 15661475
- ISSN
- 0899-9007
- eISSN
- 1873-1244
- Language
- English
- Date published
- 2005
- Academic Unit
- Pathology; VPMA - Administration
- Record Identifier
- 9984046801502771
Metrics
9 Record Views