Mortality of infants <6 mo of age supplemented with vitamin A: A randomized, double-masked trial in Nepal
American Journal of Clinical Nutrition
infant mortality; intolerance; supplementation; verbal autopsy; Vitamin A
The effect of supplementing 11 918 infants < 1 mo and 1-5 mo of age with vitamin A (15 000 and 30 000 μg retinol equivalents or 50 000 and 100 000 IU, respectively) or a placebo on subsequent 4-mo mortality was assessed in a randomized, double-masked community trial in the rural plains of Nepal. There were 130 deaths (51.6/1000 child-y) in the control group and 150 deaths (57.1/1000 child-y) in the vitamin A group, yielding a relative risk of 1.11 (95% CI: 0.86, 1.42), which is indicative of no overall effect on early infant mortality. There was a tendency for the relative risk of mortality among vitamin A recipients to rise with improved nutritional status. These results suggest that distribution of a large oral dose of vitamin A to infants < 5-6 mo of age may not benefit short-term survival. This is in contrast with the results of trials in which older infants and children in this same population were supplemented.
West, K., Katz, J., Shrestha, S., LeClerq, S., Khatry, S., Pradhan, E., Adhikari, R., Wu, L., Pokhrel, R., Sommer, A., Chataut, B., Pandey, M., Calder, D., Gmunder, J., Humphrey, J., Tielsch, J., Taylor, H., & Piet, D. (1995). Mortality of infants <6 mo of age supplemented with vitamin A: A>randomized, double-masked trial in Nepal. American Journal of Clinical Nutrition, 62 (1). http://dx.doi.org/10.1093/ajcn/62.1.143