This is an a posteriori analysis of previously published data to assess whether improving
vitamin A (VA) status resolves
measles-related
pneumonia (MP). Nonhospitalized acute
measles patients (2 d of
rash onset) had their VA status determined based on the molar ratio of
retinol-binding protein to
transthyretin (RBP/TTR). Using a cutoff value of </=0.36, indicative of marginal VA deficiency, 82 children were diagnosed as marginally VA deficient and 114 were diagnosed as VA sufficient. At baseline, marginally VA-deficient patients had significantly lower serum
retinol and higher serum
C-reactive protein concentrations than VA-sufficient children. At the 2-wk follow-up visit, serum
retinol and the RBP/TTR ratio were significantly greater in marginally VA-deficient
measles patients receiving VA supplements than in those receiving placebo; whereas in VA-sufficient
measles patients,
retinol increased in those receiving VA supplements or placebo. Concomitantly the odds ratio of unresolved
pneumonia in marginally VA-deficient
measles patients receiving VA supplements compared with those receiving placebo was 0.20 (95% confidence interval, 0.05-0.71). In conclusion, VA supplements during
measles infection improved VA status of VA-deficient children and helped resolve MP, demonstrating the importance of determining VA status when assessing the efficacy of VA supplements.