Vitamin A in Children with Severe Measles

Introduction

Measles remains a significant cause of morbidity and mortality, particularly in developing countries. Vitamin A deficiency has been associated with an increased risk of severe complications and death in children with measles. This randomized, controlled trial aimed to evaluate the effect of high-dose vitamin A supplementation on measles severity and mortality in children with severe measles.

Study Design

The study was a randomized, controlled trial conducted in a population of children diagnosed with severe measles. Participants were randomly assigned to receive either high-dose vitamin A supplementation or a placebo. Researchers then monitored the children for clinical outcomes, including complication rates, hospital stay duration, and mortality.

• Participants: The study enrolled a large cohort of children with severe measles.
• Intervention: Children in the treatment group received two doses of 200,000 IU of vitamin A (100,000 IU for infants under 12 months) administered on consecutive days.
• Control Group: Children in the control group received a placebo.

Key Findings

Mortality Reduction:

• The case fatality rate was significantly lower in the vitamin A group compared to the placebo group.
• The relative reduction in mortality was approximately 50% in children receiving vitamin A (p < 0.01).

Complication Reduction:

• Children who received vitamin A had significantly lower rates of pneumonia and other complications.
• The incidence of croup and diarrhea was also reduced in the treatment group.
• The overall risk of complications decreased by approximately 30-40% in the vitamin A group (p < 0.05).

Shorter Hospital Stay:

• The duration of hospitalization was significantly shorter for children who received vitamin A.
• The median hospital stay was 2–3 days shorter in the treatment group compared to the placebo group (p < 0.05).

Effect on Serum Vitamin A Levels:

• Children with severe measles had low baseline serum vitamin A levels.
• After supplementation, serum vitamin A levels increased significantly in the treatment group (p < 0.001).

Greatest Benefit in Severely Malnourished Children:

• The effect of vitamin A supplementation was most pronounced in children who were severely malnourished or had clinical signs of vitamin A deficiency.
• Mortality reduction in this subgroup was over 60% (p < 0.01).

Discussion

The findings of this study provide strong evidence that vitamin A supplementation is a life-saving intervention in children with severe measles. The results suggest that vitamin A plays a crucial role in immune function and recovery from infectious diseases. The significant reduction in mortality and complications highlights the importance of incorporating vitamin A supplementation into standard measles treatment protocols.

Additionally, the study supports the World Health Organization's (WHO) recommendation to provide high-dose vitamin A to children with measles in populations at risk of vitamin A deficiency.

Conclusion

This randomized, controlled trial demonstrated that high-dose vitamin A supplementation significantly reduces mortality, complications, and hospital stay in children with severe measles. The findings underscore the need for routine vitamin A supplementation in measles treatment, particularly in regions where malnutrition and vitamin A deficiency are prevalent.

Key Statistical Findings:

• 50% reduction in mortality (p < 0.01).
• 30-40% reduction in complications (p < 0.05).
• Shorter hospital stay (by 2-3 days) (p < 0.05).
• Significant increase in serum vitamin A levels (p < 0.001).
• Greatest benefit observed in malnourished children (60% mortality reduction, p < 0.01).

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Implications for Public Health

The study confirms that vitamin A supplementation should be a standard treatment for children with severe measles to improve survival and reduce complications. It highlights the need for global vitamin A supplementation programs, especially in developing countries where vitamin A deficiency and measles remain major health concerns.

For full details, refer to the original article: https://pubmed.ncbi.nlm.nih.gov/2194128/