Efficacy of vitamin A in reducing preschool child mortality in Nepal

K. P. West, J. Katz, S. C. LeClerq, E. K. Pradhan, J. M. Tielsch, A. Sommer, R. P. Pokhrel, S. K. Khatry, S. R. Shrestha, M. R. Pandey

Research output: Contribution to journalArticlepeer-review


Community trials of the efficacy of vitamin A supplementation in reducing preschool childhood mortality have produced conflicting results. To resolve the question, a randomised, double-masked, placebo-controlled community trial of 28 630 children aged 6-72 months was carried out in rural Nepal, an area representative of the Gangetic flood plain of South Asia. Randomisation was carried out by administrative ward; the vitamin-A-supplemented children received 60 000 retinol equivalents every 4 months and placebo-treated children received identical capsules containing 300 retinol equivalents. After 12 months, the relative risk of death in the vitamin-A-supplemented compared with the control group was 0·70 (95% confidence interval 0·56-0·88), equivalent to a 30% reduction in mortality. The trial, which had been planned to last 2 years, was discontinued. The reduction in mortality was present in both sexes (relative risk for boys 0·77; for girls 0·65), at all ages (range of relative risks 0·83-0·50), and throughout the year (0·76-0·67). The reduction in mortality risk was not affected by acute nutritional status, as measured by arm circumference. Thus, periodic vitamin A delivery in the community can greatly reduce child mortality in developing countries.

Original languageEnglish (US)
Pages (from-to)67-71
Number of pages5
JournalThe Lancet
Issue number8759
StatePublished - Jul 13 1991

ASJC Scopus subject areas

  • Medicine(all)


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