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Vitamin A for treating measles in childrenYang HM, Mao M, Wan CM
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SummaryVitamin A for measles in childrenMeasles is caused by a virus and possible complications include pneumonia. Measles is a major cause of death in children in low-income countries and is particularly dangerous for children with vitamin A deficiency. This review found that there was no significant reduction in mortality in children receiving vitamin A. However, vitamin A megadoses (200,000 international units on each day for two days) lowered the number of deaths from measles in hospitalized children under the age of two years. Two doses of vitamin A are not considered to be too expensive, and are not likely to produce adverse effects.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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April 23. 2001 AbstractBackgroundMeasles is a major cause of childhood morbidity and mortality. Vitamin A deficiency is a recognized risk factor for severe measles infections. The World Health Organization recommends a daily oral dose of vitamin A for two days to children with measles living in areas where vitamin A deficiency may be present. ObjectivesTo determine whether vitamin A, commenced after measles has been diagnosed, prevents mortality, pneumonia or other complications in children. Search strategyWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) which contains the Acute Respiratory Infection Group's Specialized Register (The Cochrane Library 2009, issue 1), MEDLINE (1966 to March 2009), and EMBASE (1980 to March 2009). Selection criteriaRandomized controlled trials in children with measles given vitamin A or placebo, along with standard treatment. Data collection and analysisTwo review authors independently assessed the results. We analysed dichotomous outcomes and expressed results as risk ratio (RR) with 95% confidence interval (CI). Subgroup analyses were carried out for dose, formulation, age, hospitalization, and pneumonia-specific mortality. Mean differences (MD) with 95% CI were calculated for continuous outcomes. Main resultsEight trials met the inclusion criteria (2574 participants). There was no significant reduction in the risk of mortality in the vitamin A group when all the studies were pooled (RR 0.70; 95% CI 0.42 to 1.15). The evidence suggests that vitamin A in a single dose was not associated with a reduced risk of mortality. However, two doses of vitamin A (200,000 IU on consecutive days) reduced the mortality in children aged less than two years (RR 0.18; 95% CI 0.03 to 0.61) and pneumonia-specific mortality (RR 0.33; 95% CI 0.08 to 0.92). Two doses of vitamin A reduced the incidence of croup (RR 0.53; 95% CI 0.29 to 0.89) but not pneumonia morbidity (RR 0.92; 95% CI 0.69 to 1.22), nor diarrhea morbidity (RR 0.80; 95% CI 0.27 to 2.34). Authors' conclusionsNo overall significant reduction in mortality with vitamin A therapy for children with measles was found. However two doses reduced overall and pneumonia-specific mortality in children aged less than two years. No trials directly compared a single dose with two doses. |