Original ArticlesVitamin A supplementation and childhood morbidity from diarrhea and respiratory infections: A meta-analysis☆
Section snippets
Selection of studies
A computerized search was conducted of MEDLINE databases from January 1966 to December 2000. Two combinations of key words were used: (1) (vitamin A or retinol) and (infection* or diarrhea* or diarrhea* or respiratory disease or pneumonia or measles or morbidity or mortality); (2) (vitamin A or retinol) and (trial* or double-blind or double-blind or single-blind or single-blind or controlled study or comparative study). In addition, we searched MEDLINE by names of authors of studies identified
Primary prevention of diarrhea
Figure 1 presents the RR and 95% CI of the 8 studies dealing with diarrhea; 4 reported a protective effect of vitamin A supplementation against diarrhea,22, 23, 25, 29 which was statistically significant in two of them.22, 23Four studies reported an adverse effect of vitamin A supplementation on diarrhea19, 28, 32, 36;
Discussion
Our meta-analysis indicates that vitamin A supplementation has no consistent overall protective effect on the incidence of diarrhea and that it slightly increases the incidence of respiratory tract infections. These findings are not in keeping with earlier vitamin A supplementation meta-analyses, which reported no effect on incidence of pneumonia.5, 8 However, a meta-analysis limited to community-based trials reported a slight and nonsignificant increase in deaths from respiratory tract disease
References (62)
- et al.
Impact of vitamin A supplementation on childhood mortality: A randomized controlled trial
Lancet
(1986) Vitamin A and childhood mortality
Lancet
(1993)- et al.
Effect of massive dose vitamin A on morbidity and mortality in Indian children
Lancet
(1990) - et al.
Impact of vitamin A supplementation on childhood morbidity in northern Ghana
Lancet
(1992) - et al.
Vitamin A supplementation and increased prevalence of childhood diarrhoea and acute respiratory infections
Lancet
(1993) - et al.
Effect of vitamin A supplementation on diarrhoea and acute lower-respiratory-tract infections in young children in Brazil
Lancet
(1994) - et al.
Plasma retinol level, vitamin A supplementation and acute respiratory infections in children of 1-5 years old in a developing country: Respiratory Diseases Working Group
Tuber Lung Dis
(1995) - et al.
Vitamin A supplementation, morbidity, and serum acute0phase proteins in young Ghanaian children
Am J Clin Nutr
(1995) - et al.
Vitamin A supplementation and morbidity among preschool children in south India
Am J Clin Nutr
(1995) - et al.
Dietary vitamin A intake and the incidence of diarrhoea and respiratory infection among Sudanese children
J Nutr
(1995)
Impact of neonatal vitamin A supplementation on infant morbidity and mortality
J Pediatr
Acute raspatory infections prevent improvement of vitamin A status in young infants supplemented with vitamin A
J Nutr
Vitamin A supplementation fails to reduce incidence of acute respiratory illness and diarrhoea in preschool-age Indonesian children
J Nutr
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 Nutr
Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salam, Tanzania
J Pediatr
A method for assessing the quality of a randomized control trial
Control Clin Trials
Meta-analysis in clinical trials
Control Clin Trials
Incorporating variations in the quality of individual randomized trials into meta-analysis
J Clin Epidemiol
Mild vitamin A deficiency and childhood morbidity—an Indian experience
Am J Clin Nutr
Malnutrition is a determining factor in diarrhoeal duration, but not incidence, among young children in a longitudinal study in rural Bangladesh
Am J Clin Nutr
Increased risk of respiratory disease and diarrhoea in children with preexisting mild vitamin A deficiency
Am J Clin Nutr
Antigen-specific immune response impairment in the chick as influence by dietary vitamin A
J Nutr
Decreased resistance and immune response to Escherichia coli infection in chicks with low or high intakes of vitamin A
J Nutr
Evaluation of vitamin A absorption by using oil-soluble and water-miscible vitamin A preparations in normal adults and in patients with gastrointestinal disease
Am J Clin Nutr
Clinical trial of vitamin A as adjuvant treatment for lower respiratory tract infections
J Pediatr
Vitamin A supplementation and severity of pneumonia in children admitted to the hospital in Dar es Salaam, Tanzania
Am J Clin Nutr
Vitamin A as an anti-infective agent
BMJ
Intensive vitamin therapy in measles
BMJ
Nutritional blindness: Xerophthalmia and keratomalacia
Effectiveness of vitamin A supplementation in the control of young child morbidity and mortality in developing countries
ACC/SCN State-of-the-Art Series, Nutrition Policy Discussion Paper No. 13. United Nations, Geneva, Switzerland
Vitamin A supplementation in infectious diseases: A meta-analysis
BMJ
Cited by (90)
Copula based trivariate spatial modeling of childhood illnesses in Western African countries
2023, Spatial and Spatio-temporal EpidemiologyThe efficacy of zinc supplementation in young children with acute lower respiratory infections: A randomized double-blind controlled trial
2013, Clinical NutritionCitation Excerpt :Often, deficiencies are not apparent and only show in subclinical signs, e.g. retarded linear growth and susceptibility to infection. Both zinc and vitamin A deficiency have been linked to the occurrence and severity of lower respiratory tract infections (pneumonia) and diarrheal disease.10,11 A constraint to determine the true prevalence of zinc deficiency, e.g. in young growing children, is the lack of reliable biomarkers.12,13
Vitamin A in resistance to and recovery from infection: Relevance to SARS-CoV2
2021, British Journal of Nutrition
- ☆
Reprint requests: Daniel Mimouni, MD, Johns Hopkins University School of Medicine, Department of Dermatology, Immunodermatology Laboratory, 720 Rutland Ave, Ross Building, Suite 771, Baltimore, MD 21205. E-mail:[email protected] .