Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-Bissau.
BMC Pediatr. 2013 Nov 19;13:190. doi: 10.1186/1471-2431-13-190.
The World Health Organization recommends high-dose vitamin A supplementation (VAS) for children above six months of age in low-income countries. VAS has been associated with up-regulation of the Th2 response. We aimed to determine if VAS is associated with atopy in childhood.
Infants in Guinea-Bissau were randomly allocated VAS or placebo, either at six and nine months of age, or only at nine months of age. At six months of age, children were furthermore randomized to measles vaccine or inactivated polio vaccine. At nine months of age all children received measles vaccine. Children were revisited seven years later and skin prick testing was performed. Atopy was defined as a skin prick reaction ≥ 3 mm.
40 of 263 children (15%) were atopic. Overall VAS had no significant effect on the risk of atopy (Prevalence Ratio 1.23; 95% CI 0.69-2.18). The Prevalence Ratio was 1.60 (0.66-3.90) for males and 1.00 (0.46-2.15) for females.
There was no significant effect of VAS in infancy on atopy later in childhood. The role of infant VAS in the development of atopy is still unclear.
世界卫生组织建议在低收入国家为 6 个月以上的儿童补充大剂量维生素 A（VAS）。VAS 与 Th2 反应的上调有关。我们旨在确定 VAS 是否与儿童期特应性有关。
几内亚比绍的婴儿被随机分配接受 VAS 或安慰剂，要么在 6 个月和 9 个月时，要么仅在 9 个月时接受 VAS。在 6 个月大时，儿童被进一步随机分配接受麻疹疫苗或灭活脊髓灰质炎疫苗。在 9 个月大时，所有儿童都接种了麻疹疫苗。7 年后再次对儿童进行随访，并进行皮肤点刺试验。特应性定义为皮肤点刺反应≥3 毫米。
263 名儿童中有 40 名（15%）为特应性。总体而言，VAS 对特应性的风险没有显著影响（患病率比 1.23；95%CI 0.69-2.18）。男性的患病率比为 1.60（0.66-3.90），女性为 1.00（0.46-2.15）。
婴儿时期接受 VAS 治疗对儿童后期特应性没有显著影响。婴儿时期接受 VAS 治疗在特应性发展中的作用仍不清楚。
