52621
document
Reduced mortality among children in southern India receiving a small weekly dose of vitamin A . BACKGROUND Clinical vitamin A deficiency affects millions of children worldwide , and subclinical deficiency is even more common . Supplemental vitamin A has been reported to reduce mortality among these children , but the results have been questioned . METHODS We conducted a randomized , controlled , masked clinical trial for one year in southern India involving 15,419 preschool-age children who received either 8.7 mumol ( 8333 IU ) of vitamin A and 46 mumol ( 20 mg ) of vitamin E ( the treated group ) or vitamin E alone ( the control group ) . Vitamin supplements were delivered weekly by community health volunteers who also recorded mortality and morbidity . Weekly contact was made with at least 88 percent of the children in both study groups . The base-line characteristics of the children were similar and documented a high prevalence of vitamin A deficiency and undernutrition . RESULTS One hundred twenty-five deaths occurred , of which 117 were not accidental . The risk of death in the group treated with vitamin A was less than half that in the control group ( relative risk , 0.46 ; 95 percent confidence interval , 0.30 to 0.71 ) . The risk was most reduced among children under 3 years of age ( 6 to 11 months -- relative risk , 0.28 ; 95 percent confidence interval , 0.09 to 0.85 ; 12 to 35 months -- relative risk , 0.46 ; 95 percent confidence interval , 0.26 to 0.81 ) and among those who were chronically undernourished , as manifested by stunting ( relative risk , 0.11 ; 95 percent confidence interval , 0.03 to 0.36 ) . The symptom-specific risk of mortality was significantly associated with diarrhea , convulsions , and other infection-related symptoms . CONCLUSIONS The regular provision of a supplement of vitamin A to children , at a level potentially obtainable from foods , in an area where vitamin A deficiency and under-nutrition are documented public health problems contributed substantially to children 's survival ; mortality was reduced on average by 54 percent .
52622
Intervention_Pharmacological
vitamin A
52623
Intervention_Pharmacological
8.7 mumol
52624
Intervention_Pharmacological
vitamin A
52625
Intervention_Pharmacological
46 mumol ( 20 mg ) of vitamin E
52626
Intervention_Pharmacological
vitamin E
52627
Intervention_Pharmacological
Vitamin supplements
52628
Intervention_Pharmacological
vitamin A
52629
Outcome_Mortality
mortality
52630
Outcome_Mortality
morbidity
52631
Outcome_Mortality
risk of death
52632
Outcome_Mortality
symptom-specific risk of mortality
52633
Outcome_Physical
diarrhea
52634
Outcome_Physical
convulsions
52635
Outcome_Physical
infection-related symptoms
52636
Participant_Condition
children in southern India receiving a small weekly dose of vitamin A .