Mild vitamin a deficiency and risk of respiratory tract diseases and diarrhea in preschool and school children in Northeastern Thailand

Martin W. Bloem, Michel Wedel, Robert J. Egger, Andries J. Speek, Jaap Schrijver, Sastri Saowakontha, Wil H.P. Schreurs

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A cross-sectional study, a follow-up study, and an intervention trial were carried out to investigate the association between mild vitamin A deficiency and the occurrence of diarrhea and respiratory diseases. Cross-sectional analysis was performed among 1,772 children, aged 1-8 years, in the Sakon Nakhon province of northeastern Thailand. Children with a history of diarrhea or respiratory disease had lower levels of serum retinol and retinol-binding protein. Adjusted for age, sex, nutritional status, and level of urbanization, logistic regression using data for 877 children showed a negative association between serum retinol and both diarrhea and respiratory diseases. A follow-up three months later (n = 146 children) showed that children with deficient serum retinol (<0.35 μmol/liter) had a fourfold greater risk of respiratory disease (p < 0.01). No relation was found for diarrhea. An intervention trial (n = 166 children aged 1-5 years) showed that, during 2 months of follow-up after administration of oral vitamin A (200,000 IU), the control group (aged 3-5 years) had a higher incidence of respiratory disease (2.9 times) as well as diarrhea (3.1 times). Between 2 and 4 months, a significantly (p < 0.025) higher incidence of respiratory diseases (2.5 times) could be observed in children aged 1-2 years. This study supports earlier reports on a greater risk of respiratory diseases and of diarrhea in mild vitamin A deficiency. Supplementation reduced the incidence of both diarrhea and respiratory disease for a period of at least 2 months.

Original languageEnglish (US)
Pages (from-to)332-339
Number of pages8
JournalAmerican journal of epidemiology
Issue number2
StatePublished - Feb 1990



  • Child
  • Diarrhea
  • Respiratory tract diseases
  • Vitamin A deficiency

ASJC Scopus subject areas

  • Epidemiology

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