Thomas Tinku, Sachdev Harshpal S, Ghosh Santu, Kapil Umesh, Kurpad Anura V
Department of Biostatistics, St John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, Karnataka.
Sitaram Bhartia Institute of Science and Research, New Delhi.
Indian Pediatr. 2022 Mar 15;59(3):206-209. Epub 2021 Sep 22.
To re-estimate the survival benefit from Vitamin A supplementation (VAS) in India using meta-analysis and to correlate mortality and vitamin A deficiency (VAD) in children aged 6 month to 5 year.
Pooled risk ratio (fixed effects model) for mortality reduction with VAS was calculated from available Indian studies. Computed mortality rates in 6 months to 5 years children in Indian states were regressed on VAD prevalence estimates of the states.
There was no reduction in risk of all-cause mortality with VAS (RR=0.96; 95% CI: 0.89, 1.03). When regressing mortality on VAD in high or low VAD prevalence states, the regression coefficients were discordant.
No survival benefit was observed for VAS in India from the available literature. The targeting of VAS programs should be given serious consideration.
采用荟萃分析重新评估印度维生素A补充剂（VAS）的生存获益，并关联6个月至5岁儿童的死亡率与维生素A缺乏症（VAD）。
从现有的印度研究中计算出VAS降低死亡率的合并风险比（固定效应模型）。根据各邦的VAD患病率估计值，对印度各邦6个月至5岁儿童的计算死亡率进行回归分析。
VAS并未降低全因死亡率风险（RR = 0.96；95%置信区间：0.89，1.03）。在VAD患病率高或低的邦，将死亡率与VAD进行回归分析时，回归系数不一致。
从现有文献来看，在印度未观察到VAS有生存获益。应认真考虑VAS项目的目标定位。
