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Vitamin A for preventing secondary infections in children with measles--a systematic review
Rennie M D'Souza1, Ron D'Souza
1National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia. rennie.dsouza@anu.edu.au
Abstract:
The objective of the present study was to determine whether vitamin A prevents pneumonia, diarrhoea and other infections in children with measles. A meta-analysis was carried out of randomized controlled trials identified through a systematic search of the medical literature for studies that used vitamin A to treat measles. A total of 492 children, aged from 6 months to 13 years, were supplemented with vitamin A, and 536 children were given placebo in six trials, five of which were conducted in hospitals and one in a community setting. The main outcome measures were: incidence of pneumonia, diarrhoea, croup, and otitis media; and duration of pneumonia, diarrhoea, fever and hospitalization. There was no significant reduction in the incidence of pneumonia or diarrhoea but there was a 47 per cent reduction in the incidence of croup (RR = 0.53; 95 per cent CI = 0.29-0.89) in children who were treated with 200 000 IU of vitamin A on 2 consecutive days. Only one study reported a 74 per cent reduction in the incidence of otitis media (RR = 0.26 95 per cent CI = 0.05-0.92). There was a statistically significant decrease in the duration of diarrhoea, pneumonia, hospital stay and fever in individual studies. It was concluded that vitamin A does have a beneficial effect on morbidity associated with measles and should be used as a treatment for hospitalized measles cases.
Insights
Vitamin A supplementation significantly reduced croup and otitis media incidence in children with measles. It also decreased the duration of diarrhea, pneumonia, and fever, indicating a beneficial effect on measles-related morbidity.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Measles is a significant cause of childhood morbidity and mortality globally.
- Vitamin A deficiency is common in children with measles, exacerbating disease severity.
- Previous studies suggest a potential role for vitamin A in managing measles complications.
Purpose of the Study:
- To evaluate the efficacy of vitamin A supplementation in preventing and treating infections in children with measles.
- To assess the impact of vitamin A on the incidence and duration of specific measles-related complications.
Main Methods:
- A meta-analysis of randomized controlled trials was conducted.
- Systematic literature search identified six relevant trials involving 492 children supplemented with vitamin A and 536 controls.
- Outcomes included incidence and duration of pneumonia, diarrhea, croup, otitis media, fever, and hospitalization.
Main Results:
- Vitamin A supplementation showed a 47% reduction in croup incidence and a 74% reduction in otitis media incidence.
- No significant reduction in pneumonia or diarrhea incidence was observed.
- Statistically significant decreases in the duration of diarrhea, pneumonia, fever, and hospitalization were noted.
Conclusions:
- Vitamin A treatment demonstrates a beneficial effect on measles-related morbidity.
- Supplementation is recommended for hospitalized measles cases to reduce complication severity and duration.
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