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Vitamin A in Children Hospitalized for Measles in a High-income Country
Andrea Lo Vecchio2021
Maria Donata CambrigliaDario Bruzzese
Average · 25th percentile
5 citations · Biochemistry

TLDR

Giving vitamin A to children in the hospital for measles in a wealthy country did not help them get better faster or avoid problems from the illness.

Summary

1 Study Aim

The study set out to determine whether giving vitamin A supplements to children hospitalized with measles in a high-income country, specifically Italy, would improve their recovery or reduce complications. The researchers wanted to address the lack of evidence for vitamin A use in such settings, especially since it is widely recommended for severe measles cases. Simply put: The study wanted to see if vitamin A helps kids with measles get better or avoid problems when treated in a rich country.

2 Study Design

The researchers conducted a prospective controlled cohort study, meaning they followed two groups of children over time. They enrolled 108 children admitted for measles at a large hospital in Southern Italy. Of these, 36 children received two doses of oil-based vitamin A based on their age, while 72 similar children received standard care without vitamin A. The main thing they measured was how long the children had a fever. They also looked at how long the children stayed in the hospital, how many had complications, whether they needed antibiotics, and their highest body temperature. Simply put: The study compared kids with measles who got vitamin A to those who did not, checking how sick they got and how long they stayed in the hospital.

3 Findings

The study found no significant differences between the children who received vitamin A and those who did not. Both groups had similar durations of fever, lengths of hospital stay, highest body temperatures, rates of organ and blood-related complications, and needs for antibiotics. The risk of developing complications was not lower in the vitamin A group. The authors conclude that vitamin A supplementation does not change how measles progresses or reduce complications in hospitalized children in a high-income country. Simply put: Giving vitamin A did not help kids with measles recover faster or have fewer problems in the hospital.

Abstract

BACKGROUND: Worldwide medical authorities recommend vitamin A supplementation for severe measles requiring hospitalization; however, evidence supporting its use in high-income countries is lacking. A nationwide vitamin A shortage reported in concomitance with a recent measles outbreak in Italy provided an opportunity to test the effectiveness of vitamin A in a high-income setting, approximating an unbiased allocation. METHODS: We conducted a prospective controlled cohort study involving children admitted for measles to a tertiary-care hospital in Southern Italy. The primary outcome was the duration of fever. Secondary outcomes included the length of hospitalization, rate of complications, need for antibiotic treatment and body temperature. RESULTS: A total of 108 inpatient children (36% female, median age 16.3 months) were enrolled; 36 received 2 doses of oil-based vitamin A according to age, and 72 matched controls received standard care. There were no significant differences between the study groups in the duration of fever (7.03 ± 2.67 vs. 6.82 ± 3.27, P = 0.72), length of hospitalization (median, 5.0 vs. 5.0 days, P = 0.50), maximum body temperature (median, 39°C in both groups, P = 0.23), rate of organ (69.4% vs. 63.9%, P = 0.72) and hematologic complications (41.7% vs. 59.7%, P = 0.12), or need for antibiotic treatment (66.7% vs. 61.1%, P = 0.72). Overall, vitamin A supplementation did not reduce the risk of any complications (relative risk, 1.33; 95% confidence intervals: 0.59-2.96). CONCLUSION: Vitamin A does not change the clinical course of measles infection or the rate of complications in children hospitalized in a high-income country. STUDY REGISTRATION NUMBER: EU PAS 31805.

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