It has been more than 70 years since vitamin A was first reported to play a role in the treatment of measles. the addition of vitamin A to the treatment of other common childhood illnesses remains controversial, with differing guidelines. This review analyzes the strength of the evidence for the role of vitamin A in six common childhood illnesses. We found no published papers on the use of vitamin A in chickenpox or malaria. There is strong published evidence for the use of adjuvant vitamin A in children requiring hospital admission for measles and some evidence for its use in acute shigellosis. the available evidence does not support a role for adjuvant vitamin A in acute lower respiratory tract infections or acute watery diarrhea. There is insufficient evidence on the role of vitamin A in the treatment of persistent diarrhea, acute measles not requiring admission, and protein-energy malnutrition to guide policy
References
1.
AbdeljaberM.H., MontoA.S., TildenR.L., SchorkM.A., TarwotjoI.The impact of vitamin A supplementation on morbidity: a randomized community intervention trial. Am J Public Health1991; 81: 1654–6.
2.
LieC., YingC., WangE.L., BrunT., GeisslerC.Impact of large-dose vitamin A supplementation on childhood diarrhoea, respiratory disease and growth. Eur J Clin Nutr1993; 47: 88–96.
3.
RahmathullahL.Effect of receiving a weekly dose of vitamin A equivalent to the recommended dietary allowances among pre school children on mortality in south India. Indian J Pediatr1991; 58: 837–47.
4.
SommerA., TarwotjoI., DjunaediE., WestK.P., LoedenA.A., TildenR., MeleL.Impact of vitamin A supplementation on childhood mortality. A randomised controlled community trial. Lancet1986; 1: 1169–73.
5.
EllisonJ.B.Intensive vitamin therapy in measles. BMJ1932; 2: 708–11.
6.
WHO.Integrated Management of Childhood Illness: a WHO/UNICEF Initiative. Bull WHO1997; 75(suppl 1): 1–128.
7.
WHO.Vitamin A supplements. A guide to their use in the treatment and prevention of vitamin A deficiency and xerophthalmia.Geneva: World Health Organization, 1997.
8.
PocockS.J.Clinical trials: a practical approach.Chichester, UK: John Wiley & Sons, 1983.
9.
HusseyG.D., KleinM.Routine high-dose vitamin A therapy for children hospitalized with measles. J Trop Pediatr1993; 39: 342–5.
10.
FlorentinoR.F., TanchocoC.C., RamosA.C., MendozaT.S., NatividadE.P., TangcoJ.B., SommerA.Tolerance of preschoolers to two dosage strengths of vitamin A preparation. Am J Clin Nutr1990; 52: 694–700.
11.
WestK.P., KhatryS.K., LeClerqS.C., AdhikariR., SeeL., KatzJ., ShresthaS.R., PradhanE.K., PokhrelR.P., SommerA.Tolerance of young infants to a single, large dose of vitamin A: a randomized community trial in Nepal. Bull WHO1992; 70: 733–9.
12.
HusseyG.D., KleinM.A randomized, controlled trial of vitamin A in children with severe measles. N Engl J Med1990; 323: 160–4.
13.
ÖzsoyluS., CemerogluA.P., GünayM.Vitamin A for varicella. J Pediatr1994; 125: 1017–8.
14.
NeuzilK.M., GruberW.C., GrahamB.S.Vitamin A therapy for respiratory syncytial virus infection. Pediatr Infect Dis J1997; 16: 84–5.
15.
DonnenP., DramaixM., BrasseurD., BitweR., VertongenF., HennartP.Randomized placebo-controlled clinical trial of the effect of a single high dose or daily low doses of vitamin A on the morbidity of hospitalized, malnourished children. Am J Clin Nutr1998; 68: 1254–60.
16.
HenningB., StewartK., ZamanK., AlamA.N., BrownK.H., BlackR.E.Lack of therapeutic efficacy of vitamin A for non-cholera, watery diarrhoea in Bangladeshi children. Eur J Clin Nutr1992; 46: 437–43.
17.
DewanV., PatwariA.K., JainM., DewanN.A randomized controlled trial of vitamin A supplementation in acute diarrhea. Indian Pediatr1995; 32: 21–5.
18.
HossainS., BiswasR., KabirI., SarkerS., DibleyM., FuchsG., MahalanabisD.Single dose vitamin A treatment in acute shigellosis in Bangladeshi children: randomised double blind controlled trial. BMJ1998; 316: 422–6.
19.
FaruqueA.S.G., MahalanabisD., HaqueS.S., FuchsG.J., HabteD.Double-blind, randomized, controlled trial of zinc or vitamin A supplementation in young children with acute diarrhoea. Acta Paediatr1999; 88: 154–60.
20.
YurdakokK., OzmertE., YalçinS.S., LaleliY.Vitamin A supplementation in acute diarrhoea. J Pediatr Gastroenterol Nutr2000; 31: 234–7.
21.
BreseeJ.S., FischerM., DowellS.F., JohnstonB.D., BiggsV.M., LevineR.S., LingappaJ.R., KeyserlingH.L., PetersenK.M., BakJ.R., GaryH.E., SowellA.L., RubensC.E., andersonL.J.Vitamin A therapy for children with respiratory syncytial virus infection; a multicenter trial in the United States. Pediatr Infect Dis J1996; 15: 777–82.
22.
QuinlanK.P., HayaniK.C.Vitamin A and respiratory syncytial virus infection. Serum levels and supplementation trial. Arch Pediatr Adolesc Med1996; 150: 25–30.
23.
DowellS.F., PapicZ., BreseeJ.S., LarrangaC., MendezM., SowellA.L., GaryH.E., andersonL.J., AvendanoL.F.Treatment of respiratory syncytial virus infection with vitamin A: a randomized, placebo-controlled trial in Santiago, Chile. Pediatr Infect Dis J1996; 15: 782–6.
24.
KjolhedeC.L., ChewF.J., GadomskiA.M., MarroquinD.P.Clinical trial of vitamin A as adjuvant treatment for lower respiratory tract infections. J Pediatr1995; 126: 807–12.
25.
NaculL.C., KirkwoodB.R., ArthurP., MorrisS.S., MagalhaesM., FinkM.C.Randomised, double blind, placebo controlled clinical trial of efficacy of vitamin A treatment in non-measles childhood pneumonia. BMJ1997; 315: 505–10.
26.
SiN.V., GrytterC., VyN.N.T., HueN.B., PedersenF.K.High dose vitamin A supplementation in the course of pneumonia in Vietnamese children. Acta Paediatr1997; 86: 1052–5.
27.
FawziW.W., MbiseR.L., FatakiM.R., HerreraG., KawauF., HertzmarkE., SpiegelmanD., NdossiG.Vitamin A supplementation and severity of pneumonia in children admitted to the hospital in Dar es Salaam, Tanzania. Am J Clin Nutr1998; 68: 187–92.
28.
StephensenC.B., FranchiL.M., HernandezH., CamposM., GilmanR.H., AlvarezJ.O.Adverse effects of high-dose vitamin A supplements in children hospitalised with pneumonia. Pediatrics1998; 101(5)e3: 915–6.
29.
JulienM.R., GomesA., VarandasL., RodriguesP., MalveiroF., AguiarP., KolsterenP., Van der StuyftP., HildebrandK., LabadariosD., FerrinhoP.A randomised, double-blind, placebo-controlled clinical trial of vitamin A in Mozambican children hospitalised with nonmeasles acute lower respiratory tract infections. Trop Med Int Health1999; 4: 794–800.
30.
BarclayA.J.G., FosterA., SommerA.Vitamin A supplements and mortality related to measles: a randomised clinical trial. BMJ1987; 294: 294–6.
31.
CoutsoudisA., BroughtonM., CoovadiaH.M.Vitamin A supplementation reduces measles morbidity in young African children: a randomized, placebo-controlled, double-blind trial. Am J Clin Nutr1991; 54: 890–5.
32.
MadhulikaS., KabraS.K., TalatiA.Vitamin A supplementation in post-measles complications. J Trop Pediatr1994; 40: 305–7.
33.
RosalesF.J., KjolhedeC., GoodmanS.Efficacy of a single oral dose of 200,000 IU of oil-soluble vitamin A in measles-associated morbidity. Am J Epidemiol1996; 143: 413–22.
34.
OgaroF.O., OrindaV.A., OnyangoF.E., BlackR.E.Effect of vitamin A on diarrhoeal and respiratory complications of measles. Trop Geogr Med1993; 45: 283–6.
