National Institute of Cholera and Enteric Diseases (ICMR), Kolkata, India.
Indian J Med Res. 2001 Feb;113:53-9.
a number of studies have shown the association between vitamin A deficiency and the increased risk of diarrhoeal and other childhood morbidities and mortality. However, some studies have raised controversies regarding the reduction of the incidence of diarrhoea after vitamin A supplementation to children. This study was undertaken to evaluate the effectiveness of vitamin A supplementation to young rural children in reducing the incidence of diarrhoea.
a double-blind randomized intervention trial was carried out amongst 404 rural children between 6-59 months of age to assess the impact of vitamin A supplementation on morbidity due to diarrhoea. Children aged 6-59 months were enrolled and allocated to receive either 200,000 or 50,000 IU of vitamin A and the same dose was repeated after six months. Morbidity due to diarrhoea was observed by twice-a-week household surveillance, during the subsequent one year of follow up. The incidence of diarrhoea was compared between the two supplemented groups. In addition, the overall incidence of diarrhoea n the two supplemented groups was also compared with the incidence observed during the year preceding supplementation.
the incidence of diarrhoea was similar in the two supplemented groups (Incidence Rate Ratio = 1.05. 95% C. I. 0.79-1.40). However, the overall incidence of diarrhoea among all the children in the two supplemented groups (0.56 episodes/child/year) was significantly lower than the incidence before supplementation (1.15 episodes/child/year). The Incidence Rate Ratio was 0.49 with 95% C.I 0.40-0.59.
the results of this study indicate that vitamin A supplementation in a dose of 200,000 IU, has no additional advantage over 50,000 IU, at least when the aim is to reduce the incidence of diarrhoea. For control of morbidity due to diarrhoea, vitamin A supplementation in a dose of 50,000 IU every six months appears to be adequate, cost effective and suitable for younger children.
多项研究表明，维生素 A 缺乏与儿童腹泻和其他疾病发病率和死亡率增加有关。然而，一些研究对维生素 A 补充对儿童腹泻发病率降低的效果提出了争议。本研究旨在评估对农村 6-59 月龄儿童补充维生素 A 对减少腹泻发病率的效果。
对 404 名 6-59 月龄农村儿童进行了一项双盲随机干预试验，以评估维生素 A 补充对腹泻发病的影响。入组并分配接受 20 万或 5 万国际单位维生素 A 的儿童，6 个月后重复相同剂量。在随后的 1 年随访期间，通过每两周一次的家庭监测来观察腹泻发病情况。比较两组补充剂的腹泻发病率。此外，还比较了两组补充剂儿童的总腹泻发病率与补充前一年的发病率。
两组补充剂的腹泻发病率相似（发病率比=1.05，95%置信区间 0.79-1.40）。然而，两组补充剂所有儿童的总腹泻发病率（0.56 次/儿童/年）显著低于补充前（1.15 次/儿童/年）。发病率比为 0.49，95%置信区间 0.40-0.59。
本研究结果表明，20 万国际单位剂量的维生素 A 补充没有比 5 万国际单位剂量更具优势，至少在降低腹泻发病率的目的上是如此。为控制腹泻发病，每 6 个月补充 5 万国际单位维生素 A 似乎足够、具有成本效益且适合年龄较小的儿童。
