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Randomized Controlled Trial
. 2011 Sep 1:11:77.
doi: 10.1186/1471-2431-11-77.

The impact of different doses of vitamin A supplementation on male and female mortality. A randomised trial from Guinea-Bissau

Dorthe Yakymenko  1 , Christine S Benn, Cesario Martins, Birgitte R Diness, Ane B Fisker, Amabelia Rodrigues, Peter Aaby
Affiliations
Randomized Controlled Trial

The impact of different doses of vitamin A supplementation on male and female mortality. A randomised trial from Guinea-Bissau

Dorthe Yakymenko et al. BMC Pediatr. .

Abstract

Background: Vitamin A supplementation (VAS) given to children between 6 months and 5 years of age is known to reduce mortality in low-income countries. We have previously observed that girls benefit more from a lower dose of VAS than the one recommended by WHO, the effect being strongest if diphtheria-tetanus-pertussis vaccine (DTP) was the most recent vaccination. We aimed to test these observations.

Methods: During national immunisations days in Guinea-Bissau, West Africa, combining oral polio vaccination and VAS, we randomised 8626 children between 6 months and 5 years of age to receive the dose of VAS recommended by WHO or half this dose. Mortality rate ratios (MRRs) were assessed after 6 and 12 month.

Results: The overall mortality rate among participants was lower than expected. There was no significant difference in mortality at 6 months and 12 months of follow up between the low dose VAS group and the recommended dose VAS group. The MRRs were 1.23 (0.60-2.54) after 6 months and 1.17 (0.73-1.87) after 12 months. This tendency was similar in boys and girls. The low dose was not associated with lower mortality in girls if the most recent vaccine was DTP (MRR = 0.60 (0.14-2.50) after 6 months).

Conclusion: Our sample size does not permit firm conclusions since mortality was lower than expected. We could not confirm a beneficial effect of a lower dose of VAS on mortality in girls.

Trial registration: The study was registered under clinicaltrials.gov, number NCT00168636.

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Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Kaplan-Meier survival curves in boys and girls, comparing participants with non-participants.
See this image and copyright information in PMC

References

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