Newborn vitamin A dosing reduces the case fatality but not incidence of common childhood morbidities in South India

James M. Tielsch, Lakshmi Rahmathullah, R. D. Thulasiraj, Joanne Katz, Christian Coles, S. Sheeladevi, Rajeesh John, Karthik Prakash

Research output: Contribution to journalArticle

Abstract

Vitamin A supplementation reduces mortality in young children in areas of endemic vitamin A deficiency. However, it has no impact on the incidence of common morbidities. This discrepancy has been explained by an impact on case fatality, although with the exception of hospitalized measles cases, there is little direct evidence to support this hypothesis. We assessed the impact of newborn dosing with vitamin A on the incidence and case fatality of common childhood morbidities in early infancy in a community-based, randomized trial in South India. Morbidity for each day in the previous 2 wk was assessed for the first 6 mo of life. A total of 11,619 live-born infants were enrolled and randomized to receive either 48,000 IU (50.4 μmol retinol) of oral vitamin A or placebo following delivery. There was no difference between treatment groups in the incidence of acute or chronic diarrhea, dysentery, or fever but a small increased incidence of acute respiratory illness (ARI). Case fatality for diarrhea and fever were significantly reduced in the vitamin A group compared with placebo (relative case fatality [95% CI] of 0.50 [0.27, 0.90] and 0.60 [0.40, 0.88], respectively). There was a trend in reduction of case fatality for various definitions of ARI, but the evidence for this effect was modest. Survival analysis among those with morbid episodes confirmed the case fatality analysis. This trial demonstrated that the reduction in overall mortality due to newborn vitamin A dosing was driven primarily by a reduction in case fatality among infants.

LanguageEnglish (US)
Pages2470-2474
Number of pages5
JournalJournal of Nutrition
Volume137
Issue number11
StatePublished - Nov 2007

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Vitamin A
childhood
vitamin A
morbidity
India
neonates
Newborn Infant
Morbidity
incidence
Incidence
fever
placebos
Diarrhea
diarrhea
Fever
Placebos
dysentery
Vitamin A Deficiency
Dysentery
vitamin A deficiency

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Tielsch, J. M., Rahmathullah, L., Thulasiraj, R. D., Katz, J., Coles, C., Sheeladevi, S., ... Prakash, K. (2007). Newborn vitamin A dosing reduces the case fatality but not incidence of common childhood morbidities in South India. Journal of Nutrition, 137(11), 2470-2474.

Newborn vitamin A dosing reduces the case fatality but not incidence of common childhood morbidities in South India. / Tielsch, James M.; Rahmathullah, Lakshmi; Thulasiraj, R. D.; Katz, Joanne; Coles, Christian; Sheeladevi, S.; John, Rajeesh; Prakash, Karthik.

In: Journal of Nutrition, Vol. 137, No. 11, 11.2007, p. 2470-2474.

Research output: Contribution to journalArticle

Tielsch, JM, Rahmathullah, L, Thulasiraj, RD, Katz, J, Coles, C, Sheeladevi, S, John, R & Prakash, K 2007, 'Newborn vitamin A dosing reduces the case fatality but not incidence of common childhood morbidities in South India' Journal of Nutrition, vol 137, no. 11, pp. 2470-2474.
Tielsch JM, Rahmathullah L, Thulasiraj RD, Katz J, Coles C, Sheeladevi S et al. Newborn vitamin A dosing reduces the case fatality but not incidence of common childhood morbidities in South India. Journal of Nutrition. 2007 Nov;137(11):2470-2474.
Tielsch, James M. ; Rahmathullah, Lakshmi ; Thulasiraj, R. D. ; Katz, Joanne ; Coles, Christian ; Sheeladevi, S. ; John, Rajeesh ; Prakash, Karthik. / Newborn vitamin A dosing reduces the case fatality but not incidence of common childhood morbidities in South India. In: Journal of Nutrition. 2007 ; Vol. 137, No. 11. pp. 2470-2474
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