Respiratory infections reduce the growth response to vitamin A supplementation in a randomized controlled trial

Hamam Hadi, Rebecca J. Stoltzfus, Lawrence H. Moulton, Michael J. Dibley, Keith P. West

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Studies on the effect of vitamin A supplementation on growth have yielded various results. It is possible that such growth is dependent on the burden of infectious diseases in the population. Methods. We analysed data from a randomized, double-masked, placebo-controlled trial to examine the role of respiratory infections and diarrhoea in modifying the growth response to vitamin A supplementation. A single high dose of vitamin A or placebo was given every 4 months to 1405 children aged 6-48 months, and 4430 child treatment cycles were used in this analysis. Results. Vitamin A supplementation modestly improved linear but not ponderal growth of children who experienced little respiratory infection and especially of those who had vitamin A intake below the normative requirement (< 400 RE/day). Children who received vitamin A and were free of respiratory infection grew 0.22 cm/4 months (95% CI:0.08, 0.37) more in height than the placebo group, but those with ≥ 21.5% of days of respiratory infection did not show a significant growth response to vitamin A supplementation. Children who experienced no respiratory infection and had vitamin A intake < 400 RE/day benefited most, gaining 0.31 cm/4 months (95% CI:0.10, 0.52) more in height compared to the placebo group. Diarrhoea was associated with poorer growth, but did not significantly modify the effect of vitamin A supplementation on growth. Conclusions. Vitamin A supplementation improves the linear growth of children who have a low intake of vitamin A but this impact is muted with increasing levels of respiratory infections.

Original languageEnglish (US)
Pages (from-to)874-881
Number of pages8
JournalInternational journal of epidemiology
Volume28
Issue number5
DOIs
StatePublished - 1999

Keywords

  • Diarrhoea
  • Growth
  • Preschool children
  • Respiratory infection
  • Vitamin A

ASJC Scopus subject areas

  • Epidemiology

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