Is vitamin A supplementation in children warranted?

January 01, 0001

Is vitamin A supplementation in children warranted?

These UK and Pakistani researchers performed a systematic review and meta-analysis to examine whether vitamin A supplementation in children is associated with morbidity and mortality benefits. They searched the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, Global Health, Latin American and Caribbean Health Sciences, metaRegister of Controlled Trials, and African Index Medicus for randomised trials of oral vitamin A supplements in children 6 months to 5 years of age.

The researchers report: "43 trials with about 215,633 children were included. Seventeen trials including 194?483 participants reported a 24% reduction in all cause mortality (rate ratio=0.76). Seven trials reported a 28% reduction in mortality associated with diarrhoea (0.72). Vitamin A supplementation was associated with a reduced incidence of diarrhoea (0.85) and measles (0.50) and a reduced prevalence of vision problems, including night blindness (0.32) and xerophthalmia (0.31). Three trials reported an increased risk of vomiting within the first 48 hours of supplementation (2.75)."

The researchers concluded: "Vitamin A supplementation is associated with large reductions in mortality, morbidity, and vision problems in a range of settings, and these results cannot be explained by bias. Further placebo controlled trials of vitamin A supplementation in children between 6 and 59 months of age are not required. However, there is a need for further studies comparing different doses and delivery mechanisms (for example, fortification). Until other sources are available, vitamin A supplements should be given to all children at risk of deficiency, particularly in low and middle income countries."

This systematic review and meta-analysis clearly demonstrates the benefits of vitamin A supplementation in infants and children, especially in at risk populations.

For the full abstract, click here.

BMJ 343:d5094, 25 August 2011 © 2011 BMJ Publishing Group Ltd.
Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis. Evan Mayo-Wilson, Aamer Imdad, Kurt Herzer, Mohammad Yawar Yakoob, Zulfiqar A Bhutta. Correspondence to Z A Bhutta: [email protected]

Category: T. Endocrine/Metabolic/Nutritional. Keywords: vitamin A, beta-carotene, supplementation, mortality, vision, systematic review with meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 20 September 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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