The effect of high-dose vitamin A supplementation given with bacille Calmette-Guérin vaccine at birth on infant rotavirus infection and diarrhea: a randomized prospective study from Guinea-Bissau.

Abstract

BACKGROUND:

Prophylactic vitamin A supplementation (VAS) reduces mortality and may reduce morbidity associated with diarrhea in children >6 months of age. Rotavirus is the most common cause of acute dehydrating diarrhea among children worldwide.

METHODS:

In a randomized placebo-controlled study of 50,000 IU of vitamin A versus placebo given with bacille Calmette-Guérin vaccine at birth, 287 infants were followed up with weekly interviews and stool sample obtainment to test the hypothesis that VAS reduced the risk of rotavirus infection.

RESULTS:

VAS was associated with increased risk of rotavirus infection and diarrhea (incidence rate ratio [IRR] of infection, 1.72 [95% confidence interval (CI), 1.04-2.85]; IRR of diarrhea, 3.74 [95% CI, 1.40-9.98]) among children <6 months of age. There was no effect in older children. VAS had a beneficial effect on nonrotavirus diarrhea in boys <6 months of age (IRR, 0.51; 95% CI, 0.27-0.95) and a detrimental effect in girls >6 months of age (IRR, 1.84; 95% CI, 0.96-3.55).

CONCLUSION:

VAS at birth did not reduce rotavirus morbidity. The effect of VAS on nonrotavirus diarrhea may differ by sex, being more beneficial in boys. Clinical trials registration. NCT00168597 .

• Authors: Birgitte Rode Diness, Dorthe Christoffersen, Ulla Britt Pedersen, Amabelia Rodrigues, Thea Kølsen Fischer, Andreas Andersen, Hilton Whittle, Maria Yazdanbakhsh, Peter Aaby, Christine Stabell Benn
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 202 Suppl Pg. S243-51 (Sep 01 2010) ISSN: 1537-6613 [Electronic] United States
• PMID: 20684711 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• BCG Vaccine
• Vitamins
• Vitamin A

Topics

• Age Factors
• BCG Vaccine (administration & dosage)
• Diarrhea (epidemiology, prevention & control, virology)
• Disease Outbreaks (prevention & control)
• Female
• Guinea-Bissau (epidemiology)
• Humans
• Incidence
• Infant
• Infant, Newborn
• Male
• Rotavirus Infections (epidemiology, prevention & control)
• Sex Factors
• Vitamin A (administration & dosage, therapeutic use)
• Vitamins (administration & dosage, therapeutic use)