Mortality of infants <6 mo of age supplemented with vitamin A: A randomized, double-masked trial in Nepal

Keith P. West; Joanne Katz; Sharada Ram Shrestha; Steven C. LeClerq; Subarna Khatry; Elizabeth K. Pradhan; Ramesh Adhikari; Lee Shu Fune Wu; Ram Prasad Pokhrel; Alfred Sommer; B. D. Chataut; M. R. Pandey; D. Calder; J. Gmunder; J. Humphrey; James M Tielsch; H. Taylor; D. Piet; J. Canner; N. N. Achariya; D. N. Mandal; T. R. Sakya; B. B. Shrestha; R. K. Shrestha

doi:10.1093/ajcn/62.1.143

Mortality of infants <6 mo of age supplemented with vitamin A: A randomized, double-masked trial in Nepal

Keith P. West, Joanne Katz, Sharada Ram Shrestha, Steven C. LeClerq, Subarna Khatry, Elizabeth K. Pradhan, Ramesh Adhikari, Lee Shu Fune Wu, Ram Prasad Pokhrel, Alfred Sommer, B. D. Chataut, M. R. Pandey, D. Calder, J. Gmunder, J. Humphrey, James M Tielsch, H. Taylor, D. Piet, J. Canner, N. N. AchariyaD. N. Mandal, T. R. Sakya, B. B. Shrestha, R. K. Shrestha

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

104 Scopus citations

Abstract

The effect of supplementing 11 918 infants < 1 mo and 1-5 mo of age with vitamin A (15 000 and 30 000 μg retinol equivalents or 50 000 and 100 000 IU, respectively) or a placebo on subsequent 4-mo mortality was assessed in a randomized, double-masked community trial in the rural plains of Nepal. There were 130 deaths (51.6/1000 child-y) in the control group and 150 deaths (57.1/1000 child-y) in the vitamin A group, yielding a relative risk of 1.11 (95% CI: 0.86, 1.42), which is indicative of no overall effect on early infant mortality. There was a tendency for the relative risk of mortality among vitamin A recipients to rise with improved nutritional status. These results suggest that distribution of a large oral dose of vitamin A to infants < 5-6 mo of age may not benefit short-term survival. This is in contrast with the results of trials in which older infants and children in this same population were supplemented.

Original language	English (US)
Pages (from-to)	143-148
Number of pages	6
Journal	American Journal of Clinical Nutrition
Volume	62
Issue number	1
DOIs	https://doi.org/10.1093/ajcn/62.1.143
State	Published - Jul 1995

Keywords

Vitamin A
infant mortality
intolerance
supplementation
verbal autopsy

ASJC Scopus subject areas

Medicine (miscellaneous)
Nutrition and Dietetics

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10.1093/ajcn/62.1.143

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West, K. P., Katz, J., Shrestha, S. R., LeClerq, S. C., Khatry, S., Pradhan, E. K., Adhikari, R., Wu, L. S. F., Pokhrel, R. P., Sommer, A., Chataut, B. D., Pandey, M. R., Calder, D., Gmunder, J., Humphrey, J., Tielsch, J. M., Taylor, H., Piet, D., Canner, J., ... Shrestha, R. K. (1995). Mortality of infants <6 mo of age supplemented with vitamin A: A randomized, double-masked trial in Nepal. American Journal of Clinical Nutrition, 62(1), 143-148. https://doi.org/10.1093/ajcn/62.1.143

West, KP , Katz, J, Shrestha, SR, LeClerq, SC, Khatry, S, Pradhan, EK, Adhikari, R, Wu, LSF, Pokhrel, RP, Sommer, A, Chataut, BD, Pandey, MR, Calder, D, Gmunder, J, Humphrey, J, Tielsch, JM, Taylor, H, Piet, D, Canner, J, Achariya, NN, Mandal, DN, Sakya, TR, Shrestha, BB & Shrestha, RK 1995, 'Mortality of infants <6 mo of age supplemented with vitamin A: A randomized, double-masked trial in Nepal', American Journal of Clinical Nutrition, vol. 62, no. 1, pp. 143-148. https://doi.org/10.1093/ajcn/62.1.143

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abstract = "The effect of supplementing 11 918 infants < 1 mo and 1-5 mo of age with vitamin A (15 000 and 30 000 μg retinol equivalents or 50 000 and 100 000 IU, respectively) or a placebo on subsequent 4-mo mortality was assessed in a randomized, double-masked community trial in the rural plains of Nepal. There were 130 deaths (51.6/1000 child-y) in the control group and 150 deaths (57.1/1000 child-y) in the vitamin A group, yielding a relative risk of 1.11 (95% CI: 0.86, 1.42), which is indicative of no overall effect on early infant mortality. There was a tendency for the relative risk of mortality among vitamin A recipients to rise with improved nutritional status. These results suggest that distribution of a large oral dose of vitamin A to infants < 5-6 mo of age may not benefit short-term survival. This is in contrast with the results of trials in which older infants and children in this same population were supplemented.",

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AU - LeClerq, Steven C.

AU - Khatry, Subarna

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AU - Adhikari, Ramesh

AU - Wu, Lee Shu Fune

AU - Pokhrel, Ram Prasad

AU - Sommer, Alfred

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AU - Pandey, M. R.

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AU - Gmunder, J.

AU - Humphrey, J.

AU - Tielsch, James M

AU - Taylor, H.

AU - Piet, D.

AU - Canner, J.

AU - Achariya, N. N.

AU - Mandal, D. N.

AU - Sakya, T. R.

AU - Shrestha, B. B.

AU - Shrestha, R. K.

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N2 - The effect of supplementing 11 918 infants < 1 mo and 1-5 mo of age with vitamin A (15 000 and 30 000 μg retinol equivalents or 50 000 and 100 000 IU, respectively) or a placebo on subsequent 4-mo mortality was assessed in a randomized, double-masked community trial in the rural plains of Nepal. There were 130 deaths (51.6/1000 child-y) in the control group and 150 deaths (57.1/1000 child-y) in the vitamin A group, yielding a relative risk of 1.11 (95% CI: 0.86, 1.42), which is indicative of no overall effect on early infant mortality. There was a tendency for the relative risk of mortality among vitamin A recipients to rise with improved nutritional status. These results suggest that distribution of a large oral dose of vitamin A to infants < 5-6 mo of age may not benefit short-term survival. This is in contrast with the results of trials in which older infants and children in this same population were supplemented.

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Mortality of infants <6 mo of age supplemented with vitamin A: A randomized, double-masked trial in Nepal

Abstract

Keywords

ASJC Scopus subject areas

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