Vitamin A for treating measles in children

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Review 1 Mention

Y Huiming•2005

W ChaominM Meng

Few Citations

130 citations

Open Access

TLDR

Giving two large doses of vitamin A to young children with measles can lower their risk of dying, especially from lung infections, but a single dose does not help.

Summary

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1 Study Aim

The main goal of this review is to find out if giving vitamin A to children after they are diagnosed with measles helps prevent death, pneumonia (lung infection), and other serious problems. The authors focus on whether vitamin A treatment is helpful in areas where children might not get enough of this vitamin. Simply put: The study wants to see if vitamin A helps kids with measles get better and avoid serious illness or death.

2 Study Design

The authors conducted a systematic review of randomized controlled trials (RCTs), which are studies where children with measles were randomly given either vitamin A or a placebo (a fake treatment) along with standard care. They searched several medical databases for studies up to 2005 and included only those that compared vitamin A treatment started after measles diagnosis. The researchers analyzed the results using statistical methods to compare risks of death and complications between groups, and they looked at different doses, ages, and specific outcomes like pneumonia. Simply put: The researchers looked at many high-quality studies where kids with measles got vitamin A or not, and compared how they did.

3 Findings

The review shows that, overall, giving vitamin A to children with measles did not significantly lower the risk of death when all studies were combined. However, when children under two years old received two large doses of vitamin A on consecutive days, their risk of dying and dying from pneumonia was much lower. There was no benefit seen with just one dose. Two doses also reduced the chance of getting croup (a breathing problem), but did not clearly lower the risk of pneumonia or diarrhea. The authors recommend two doses of vitamin A for young children with measles, especially in areas where vitamin A deficiency is common. Simply put: Two big doses of vitamin A help save the lives of young kids with measles, but one dose is not enough.

Abstract

BACKGROUND: Measles is a major cause of childhood morbidity and mortality. Vitamin A deficiency is a recognized risk factor for severe measles infections. The World Health Organization (WHO) recommends administration of an oral dose of vitamin A (200,000 international units (IU), or 100,000 IU in infants) each day for two days to children with measles when they live in areas where vitamin A deficiency may be present. OBJECTIVES: To determine whether vitamin A therapy, commenced after measles has been diagnosed, is beneficial in preventing mortality, pneumonia and other secondary complications in children. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to March 2005), EMBASE (1980 to December 2004) and looked for unpublished studies. SELECTION CRITERIA: Only randomized controlled trials in which children with measles were given vitamin A or placebo along with standard treatment were considered. DATA COLLECTION AND ANALYSIS: Studies were assessed independently by two authors. The analysis of dichotomous outcomes was done using the StatXact software and results expressed as relative risk (RR) with 95% confidence interval (CI). Subgroup analyses were carried out for dose, formulation, age, hospitalization and pneumonia-specific mortality. Weighted mean differences (WMD) with 95% CI were calculated for continuous outcomes. MAIN RESULTS: There was no significant reduction in the risk of mortality in the vitamin A group when all the studies were pooled using the random-effects model (RR 0.70; 95% CI 0.42 to 1.15). Using two doses of vitamin A (200,000 IU) on consecutive days was associated with a reduction in the risk of mortality in children under the age of two years (RR 0.18; 95% CI 0.03 to 0.61) and a reduction in the risk of pneumonia-specific mortality (RR 0.33; 95% CI 0.08 to 0.92). There was no evidence that vitamin A in a single dose was associated with a reduced risk of mortality among children with measles. There was a reduction in the incidence of croup (RR 0.53; 95% CI 0.29 to 0.89) but no significant reduction in the incidence of pneumonia (RR 0.92; 95% CI 0.69 to 1.22) or diarrhoea (RR 0.80; 95% CI 0.27 to 2.34) with two doses. AUTHORS' CONCLUSIONS: Although we found no overall significant reduction in mortality with vitamin A therapy for children with measles there was evidence that two doses were associated with a reduced risk of mortality and pneumonia-specific mortality in children under the age of two years. There were no trials that directly compared a single dose with two doses.

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