Breast-feeding status alters the effect of vitamin A treatment during acute diarrhea in children
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N Bhandari1, R Bahl, S Sazawal
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Vitamin A supplementation during acute diarrhea significantly reduced the risk of persistent diarrhea in children. This vitamin A treatment was particularly beneficial for non-breast-fed children, decreasing episode duration and severity.
Area of Science:
- Pediatrics
- Nutritional Science
- Infectious Disease Epidemiology
Background:
- Vitamin A deficiency is a global health concern, particularly in children.
- Vitamin A supplementation is known to reduce the incidence of severe diarrhea in children over subsequent months.
- The impact of vitamin A treatment during an active diarrheal episode requires further investigation.
Purpose of the Study:
- To evaluate the effect of vitamin A administration during acute diarrhea on episode duration and severity in children aged 1 to 5 years.
Main Methods:
- A double-blind, placebo-controlled field trial involving 900 children with acute diarrhea (< or = 7 days duration).
- Children were randomly assigned to receive either vitamin A (60 mg) or a placebo.
- Home follow-ups were conducted every alternate day until recovery, with data collected on diarrheal duration, stool frequency, and severity.
Main Results:
- Vitamin A treatment significantly lowered the risk of persistent diarrhea in all children (OR 0.30, 95% CI 0.07-0.97).
- In non-breast-fed children, vitamin A significantly reduced mean diarrheal duration (GM ratio 0.84), mean stools passed (GM ratio 0.73), episode duration > or = 14 days, and watery stools (OR 0.40).
- No significant effect on mean diarrheal duration or stool frequency was observed in the overall group or in breast-fed children.
Conclusions:
- Vitamin A administration during acute diarrhea may reduce episode severity and the risk of persistent diarrhea, especially in non-breast-fed children.
- The benefits observed in non-breast-fed children suggest a potential role for vitamin A in managing acute diarrheal illness in this subgroup.
- Further research may be needed to elucidate the mechanisms and confirm benefits in different populations.
Abstract:
Vitamin A administration in children reduces the incidence of severe diarrhea during the subsequent few months. We therefore examined the effect of treatment with vitamin A during acute diarrhea on the episode duration and severity. In a double-blind controlled field trial, 900 children 1 to 5 y of age with acute diarrhea of < or = 7 d duration were randomly assigned to receive vitamin A (60 mg) or a placebo. Children were followed up at home every alternate day until they recovered from the diarrheal episode. In all study children, those treated with vitamin A had a significantly lower risk of persistent diarrhea [odds ratio (OR) 0.30, 95% confidence interval (CI) 0.07-0.97], but there was no effect on the mean diarrheal duration or the mean stool frequency, in the subgroup of children who were not breast-fed, the mean diarrheal duration [ratio of geometric means (GM) 0.84, 95% CI 0.72-0.97], mean number of stools passed after the intervention (ratio of GM 0.73, 95% CI 0.56-0.95), the proportion of episodes lasting > or = 14 d (P = 0.002) and the percentage of children who passed watery stools on any study day (OR 0.40, 95% CI 0.21-0.77) were significantly lower in those treated with vitamin A. We conclude that administration of vitamin A during acute diarrhea may reduce the severity of the episode and the risk of persistent diarrhea in non-breast-fed children. Similar benefit was not seen in breast-fed children.