CoChat
Sign Up
Cited by 513Child Nutrition and Water AccessGlobal Maternal and Child HealthVitamin D Research Studies

The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.

Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age

Open access
Imdad, Aamer, Mayo-Wilson, Evan, Herzer, Kurt, Bhutta, Zulfiqar A·2017·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd008524.pub3PMC PMC6464706
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Vitamin A deficiency (VAD) is a major public health problem in low- and middle-income countries, affecting 190 million children under five years of age and leading to many adverse health consequences, including death. Based on prior evidence and a previous version of this review, the World Health Organization has continued to recommend vitamin A supplementation for children aged 6 to 59 months. There are new data available from recently published randomised trials since the previous publication of this review in 2010, and this update incorporates this information and reviews the evidence. OBJECTIVES: To assess the effects of vitamin A supplementation (VAS) for preventing morbidity and mortality in children aged six months to five years. SEARCH METHODS: In March 2016 we searched CENTRAL, Ovid MEDLINE, Embase, six other databases, and two trials registers. We also checked reference lists and contacted relevant organisations and researchers to identify additional studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) and cluster-RCTs evaluating the effect of synthetic VAS in children aged six months to five years living in the community. We excluded studies involving children in hospital and children with disease or infection. We also excluded studies evaluating the effects of food fortification, consumption of vitamin A rich foods, or beta-carotene supplementation. DATA COLLECTION AND ANALYSIS: For this update, two reviewers independently assessed studies for inclusion and abstracted data, resolving discrepancies by discussion. We performed meta-analyses for outcomes, including all-cause and cause-specific mortality, disease, vision, and side effects. We used the GRADE approach to assess the quality of the evidence. MAIN RESULTS: We identified 47 studies (4 of which are new to this review), involving approximately 1,223,856 children. Studies took place in 19 countries: 30 (63%) in Asia, 16 of these in India; 8 (17%) in Africa; 7 (15%) in Latin America, and 2 (4%) in Australia. About one-third of the studies were in urban/periurban settings, and half were in rural settings; the remaining studies did not clearly report settings. Most of the studies included equal numbers of girls and boys and lasted about a year. The included studies were at variable overall risk of bias; however, evidence for the primary outcome was at low risk of bias. A meta-analysis for all-cause mortality included 19 trials (1,202,382 children). At longest follow-up, there was a 12% observed reduction in the risk of all-cause mortality for vitamin A compared with control using a fixed-effect model (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.83 to 0.93; high-quality evidence). This result was sensitive to choice of model, and a random-effects meta-analysis showed a different summary estimate (24% reduction: RR 0.76, 95% CI 0.66 to 0.88); however, the confidence intervals overlapped with that of the fixed-effect model. Nine trials reported mortality due to diarrhoea and showed a 12% overall reduction for VAS (RR 0.88, 95% CI 0.79 to 0.98; 1,098,538 participants; high-quality evidence). There was no significant effect for VAS on mortality due to measles, respiratory disease, and meningitis. VAS reduced incidence of diarrhoea (RR 0.85, 95% CI 0.82 to 0.87; 15 studies; 77,946 participants; low-quality evidence) and measles (RR 0.50, 95% CI 0.37 to 0.67; 6 studies; 19,566 participants; moderate-quality evidence). However, there was no significant effect on incidence of respiratory disease or hospitalisations due to diarrhoea or pneumonia. There was an increased risk of vomiting within the first 48 hours of VAS (RR 1.97, 95% CI 1.44 to 2.69; 4 studies; 10,541 participants; moderate-quality evidence). AUTHORS' CONCLUSIONS: Vitamin A supplementation is associated with a clinically meaningful reduction in morbidity and mortality in children. Therefore, we suggest maintaining the policy of universal supplementation for children under five years of age in populations at risk of VAD. Further placebo-controlled trials of VAS in children between six months and five years of age would not change the conclusions of this review, although studies that compare different doses and delivery mechanisms are needed. In populations with documented vitamin A deficiency, it would be unethical to conduct placebo-controlled trials.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/14651858.cd008524.pub3

Cites

0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Flagged first, then by citations

Show all 0 references

Research works printed but not linked: 183

  1. Agarwal, 1995, Vitamin A administration and preschool child mortality, Nutrition Research, 15, 669, 10.1016/0271-5317(95)00034-G · DOI
  2. Albert, 2003, Supplementation with zinc, but not vitamin A, improves seroconversion to vibriocidal antibody in children given an oral cholera vaccine, Journal of Infectious Diseases, 187, 909, 10.1086/368132 · DOI
  3. Arya, 2000, Evaluation of safety of oral vitamin 'A' megadose co-administered with measles vaccination, Indian Pediatrics, 37, 1341
  4. Bahl R Kumar R Bhandari N Kant S Srivastava R Bhan MK Vitamin A administered with measles vaccine to nine-month-old infants does not reduce vaccine immunogenicity Journal of Nutrition 1999 1569 73 · DOI
  5. Andreozzi, 2006, Random-effects models in investigating the effect of vitamin A in childhood diarrhea, Annals of Epidemiology, 16, 241, 10.1016/j.annepidem.2005.08.007 · DOI
  6. Barreto ML Santos LM Assis AM Araújo MP Farenzena GG Santos PA Effect of vitamin A supplementation on diarrhoea and acute lower-respiratory-tract infections in young children in Brazil Lancet 1994 228 31 · DOI
  7. Benn, 1997, Randomised trial of effect of vitamin A supplementation on antibody response to measles vaccine in Guinea-Bissau, West Africa, Lancet, 350, 101, 10.1016/S0140-6736(96)12019-5 · DOI
  8. Benn, 2000, No strong long-term effect of vitamin A supplementation in infancy on CD4 and CD8 T-cell subsets. A community study from Guinea-Bissau, West Africa, Annals of Tropical Paediatrics, 20, 259, 10.1080/02724936.2000.11748145 · DOI
  9. Biswas, 1994, Effect of vitamin A supplementation on diarrhoea and acute respiratory tract infection in children. A double blind placebo controlled trial in a Calcutta slum community, European Journal of Epidemiology, 10, 57, 10.1007/BF01717453 · DOI
  10. Chen, 2013, Effect of simultaneous supplementation of vitamin A and iron on diarrheal and respiratory tract infection in preschool children in Chengdu City, China, Nutrition, 29, 1197, 10.1016/j.nut.2013.03.025 · DOI
  11. Chen, 2014, Effect of vitamin A supplements on iron metabolic homeostasis for preschoolers, Chinese Journal of Preventive Medicine, 48, 18
  12. Chen, 2013, Effect of simultaneous supplementation of vitamin A and iron on diarrheal and respiratory tract infection in preschool children in Chengdu City, China, Nutrition, 29, 1197, 10.1016/j.nut.2013.03.025 · DOI
  13. Chen, 2014, Effect of vitamin A supplements on iron metabolic homeostasis for preschoolers, Chinese Journal of Preventive Medicine, 48, 18
  14. Lie, 1993, Impact of large-dose vitamin A supplementation on childhood diarrhoea, respiratory disease and growth, European Journal of Clinical Nutrition, 47, 88
  15. Cherian, 2003, Effect of vitamin A supplementation on the immune response to measles vaccination, Vaccine, 21, 2418, 10.1016/S0264-410X(03)00060-4 · DOI
  16. Chowdhury, 2002, Effect of vitamin A supplementation on childhood morbidity and mortality, Indian Journal of Medical Sciences, 56, 259
  17. Daulaire, 1992, Childhood mortality after a high dose of vitamin A in a high risk population, BMJ, 304, 207, 10.1136/bmj.304.6821.207 · DOI
  18. Awasthi, 2013, Vitamin A supplementation every 6 months with retinol in 1 million pre-school children in north India: DEVTA, a cluster-randomised trial, Lancet, 381, 1469, 10.1016/S0140-6736(12)62125-4 · DOI
  19. Awasthi, 2013, Population deworming every 6 months with albendazole in 1 million pre-school children in North India: DEVTA, a cluster-randomised trial, Lancet, 381, 1478, 10.1016/S0140-6736(12)62126-6 · DOI
  20. Dibley, 1996, Vitamin A supplementation fails to reduce incidence of acute respiratory illness and diarrhea in preschool-age Indonesian children, Journal of Nutrition, 126, 434, 10.1093/jn/126.2.434 · DOI
  21. Hadi, 2004, Complex interactions with infection and diet may explain seasonal growth responses to vitamin A in preschool aged Indonesian children, European Journal of Clinical Nutrition, 58, 990, 10.1038/sj.ejcn.1601920 · DOI
  22. Hadi, 2000, Vitamin A supplementation selectively improves the linear growth of Indonesian preschool children: results from a randomized controlled trial, American Journal of Clinical Nutrition, 71, 507, 10.1093/ajcn/71.2.507 · DOI
  23. Hadi, 1999, Respiratory infections reduce the growth response to vitamin A supplementation in a randomized controlled trial, International Journal of Epidemiology, 28, 874, 10.1093/ije/28.5.874 · DOI
  24. Donnen, 1998, Vitamin A supplementation but not deworming improves growth of malnourished preschool children in eastern Zaire, Journal of Nutrition, 128, 1320, 10.1093/jn/128.8.1320 · DOI
  25. Donnen, 1998, Malnourished children morbidity following vitamin A supplementation or deworming in Democratic Republic of Congo, Archives of Public Health, 56, 109
  26. Fisker, 2013, High-dose vitamin A supplementation administered with vaccinations after 6 months of age: sex-differential adverse reactions and morbidity, Vaccine, 31, 3191, 10.1016/j.vaccine.2013.04.072 · DOI
  27. Fisker, 2014, High-dose vitamin A with vaccination after 6 months of age: a randomized trial, Pediatrics, 134, e739, 10.1542/peds.2014-0550 · DOI
  28. Fisker, 2013, A randomised trial of high-dose vitamin A at vaccination contacts after 6 months of age: sex-differential effects on mortality, European Journal of Epidemiology, 28, S229
  29. Jensen, 2016, The effects of vitamin A supplementation with measles vaccine on leucocyte counts and in vitro cytokine production, British Journal of Nutrition, 115, 619, 10.1017/S0007114515004869 · DOI
  30. Florentino, 1990, Tolerance of preschoolers to two dosage strengths of vitamin A preparation, American Journal of Clinical Nutrition, 52, 694, 10.1093/ajcn/52.4.694 · DOI
  31. Fawzi, 1993, Vitamin A supplementation and dietary vitamin A in relation to the risk of xerophthalmia, American Journal of Clinical Nutrition, 58, 385, 10.1093/ajcn/58.3.385 · DOI
  32. Fawzi, 1994, Dietary vitamin A intake and the risk of mortality among children, American Journal of Clinical Nutrition, 59, 401, 10.1093/ajcn/59.2.401 · DOI
  33. Fawzi, 1995, Dietary vitamin A intake and the incidence of diarrhea and respiratory infection among Sudanese children, Journal of Nutrition, 125, 1211, 10.1093/jn/125.5.1211 · DOI
  34. Fawzi, 1997, The effect of vitamin A supplementation on the growth of preschool children in the Sudan, American Journal of Public Health, 87, 1359, 10.2105/AJPH.87.8.1359 · DOI
  35. Herrera, 1992, Vitamin A supplementation and child survival, Lancet, 340, 267, 10.1016/0140-6736(92)92357-L · DOI
  36. Kartasasmita, 1995, Plasma retinol level, vitamin A supplementation and acute respiratory infections in children of 1-5 years old in a developing country, Tubercle and Lung Disease, 76, 563, 10.1016/0962-8479(95)90535-9 · DOI
  37. Lima, 2010, Effects of vitamin A supplementation on intestinal barrier function, growth, total parasitic, and specific Giardia spp infections in Brazilian children: a prospective randomized, double-blind, placebo-controlled trial, Journal of Pediatric Gastroenterology and Nutrition, 50, 309, 10.1097/MPG.0b013e3181a96489 · DOI
  38. Lima, 2014, Effects of glutamine alone or in combination with zinc and vitamin A on growth, intestinal barrier function, stress and satiety-related hormones in Brazilian shantytown children, Clinics, 69, 225, 10.6061/clinics/2014(04)02 · DOI
  39. Lima, 2013, Zinc, vitamin A, and glutamine supplementation in Brazilian shantytown children at risk for diarrhea results in sex-specific improvements in verbal learning, Clinics, 68, 351, 10.6061/clinics/2013(03)OA11 · DOI
  40. Lin, 2008, Effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency in China, European Journal of Clinical Nutrition, 62, 1412, 10.1038/sj.ejcn.1602881 · DOI
  41. Lin, 2009, Effect of beta-carotene supplementation on health and growth of vitamin A deficient children in China rural villages: a randomized controlled trial, e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, 4, e17, 10.1016/j.eclnm.2008.09.001 · DOI
  42. Long K Moran N Santos J Rosado J Estrada-Garcia T Impact of vitamin A and zinc on diarrheal e. Coli infections and associated diarrheal episodes among children in Mexico City, Mexico Annals of Nutrition and Metabolism. Abstracts of the 20th International Congress of Nutrition; 2013 September 15-20; Granada, Spain 2013 170
  43. Long K Vasan P Raga H Santos J Rosado J Mamun A Household water access and sanitation as indicators of vitamin A and zinc efficacy on gut parasite resolution Annals of Nutrition and Metabolism. Abstracts of the 20th International Congress of Nutrition; 2013 September 15-20; Granada, Spain 2013 221
  44. Long, 2006, A double-blind, randomized, clinical trial of the effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections in children in Mexico City, Mexico, American Journal of Clinical Nutrition, 83, 693, 10.1093/ajcn.83.3.693 · DOI
  45. Rosado, 2009, Interaction of zinc or vitamin A supplementation and specific parasite infections on Mexican infants' growth: a randomized clinical trial, European Journal of Clinical Nutrition, 63, 1176, 10.1038/ejcn.2009.53 · DOI
  46. Long, 2006, A double-blind, randomized, clinical trial of the effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections in children in Mexico City, Mexico, American Journal of Clinical Nutrition, 83, 693, 10.1093/ajcn.83.3.693 · DOI
  47. Long, 2006, The effect of vitamin A supplementation on the intestinal immune response in Mexican children is modified by pathogen infections and diarrhea, Journal of Nutrition, 136, 1365, 10.1093/jn/136.5.1365 · DOI
  48. Long, 2007, Supplementation with vitamin A reduces watery diarrhoea and respiratory infections in Mexican children, British Journal of Nutrition, 97, 337, 10.1017/S0007114507257757 · DOI
  49. Long, 2006, Impact of vitamin A on selected gastrointestinal pathogen infections and associated diarrheal episodes among children in Mexico City, Mexico, Journal of Infectious Diseases, 194, 1217, 10.1086/508292 · DOI
  50. Pant CR Pokharel GP Curtale F Pokhrel RP Grosse RN Lepkowski J Impact of nutrition education and mega-dose vitamin A supplementation on the health of children in Nepal Bulletin of the World Health Organization 1996 533 45
  51. Pokharel, 1998, Nutrition education and mega-dose vitamin A supplementation in Nepal, Indian Journal of Pediatrics, 65, 547, 10.1007/BF02730892 · DOI
  52. Pinnock, 1986, Vitamin A status in children who are prone to respiratory tract infections, Australian Paediatric Journal, 22, 95
  53. Pinnock, 1988, Vitamin A status of children with a history of respiratory syncytial virus infection in infancy, Australian Paediatric Journal, 24, 286
  54. Rahman, 2002, Short-term supplementation with zinc and vitamin A has no significant effect on the growth of undernourished Bangladeshi children, American Journal of Clinical Nutrition, 75, 87, 10.1093/ajcn/75.1.87 · DOI
  55. Rahman, 2001, Simultaneous zinc and vitamin A supplementation in Bangladeshi children: randomised double blind controlled trial, BMJ, 323, 314, 10.1136/bmj.323.7308.314 · DOI
  56. Rahman, 2002, Synergistic effect of zinc and vitamin A on the biochemical indexes of vitamin A nutrition in children, American Journal of Clinical Nutrition, 75, 92, 10.1093/ajcn/75.1.92 · DOI
  57. Rahmathullah, 1991, Effect of receiving a weekly dose of vitamin A equivalent to the recommended dietary allowances among pre school children on mortality in south India, Indian Journal of Pediatrics, 58, 837, 10.1007/BF02825447 · DOI
  58. Rahmathullah, 1991, Diarrhea, respiratory infections, and growth are not affected by a weekly low-dose vitamin A supplement: a masked, controlled field trial in children in southern India, American Journal of Clinical Nutrition, 54, 568, 10.1093/ajcn/54.3.568 · DOI
  59. Rahmathullah, 1990, Reduced mortality among children in southern India receiving a small weekly dose of vitamin A, New England Journal of Medicine, 323, 929, 10.1056/NEJM199010043231401 · DOI
  60. Rahmathullah, 1991, Vitamin A supplementation reduces childhood mortality, National Medical Journal of India, 4, 187
  61. Ramakrishnan, 1995, Vitamin A supplementation does not improve growth of preschool children: a randomized, double-blind field trial in south India, Journal of Nutrition, 125, 202, 10.1093/jn/125.2.202 · DOI
  62. Ramakrishnan, 1995, Vitamin A supplementation and morbidity among preschool children in south India, American Journal of Clinical Nutrition, 61, 1295, 10.1093/ajcn/61.6.1295 · DOI
  63. Cherian, 2001, Vitamin A supplementation in children with recurrent respiratory infections, Indian Pediatrics, 38, 771
  64. Reddy, 1986, Effect of deworming and vitamin A administration on serum vitamin A levels in preschool children, Journal of Tropical Pediatrics, 32, 196, 10.1093/tropej/32.4.196 · DOI
  65. Reddy, 1986, Effect of deworming and vitamin A administration on serum vitamin A levels in preschool children, Journal of Tropical Pediatrics, 32, 196, 10.1093/tropej/32.4.196 · DOI
  66. Benn, 2009, Does vitamin A supplementation interact with routine vaccinations? An analysis of the Ghana Vitamin A Supplementation Trial, American Journal of Clinical Nutrition, 90, 629, 10.3945/ajcn.2009.27477 · DOI
  67. Binka, 1995, Vitamin A supplementation and childhood malaria in northern Ghana, American Journal of Clinical Nutrition, 61, 853, 10.1093/ajcn/61.4.853 · DOI
  68. Dollimore, 1997, Measles incidence, case fatality, and delayed mortality in children with or without vitamin A supplementation in rural Ghana, American Journal of Epidemiology, 146, 646, 10.1093/oxfordjournals.aje.a009330 · DOI
  69. Filteau, 1995, Vitamin A supplementation, morbidity, and serum acute-phase proteins in young Ghanaian children, American Journal of Clinical Nutrition, 62, 434, 10.1093/ajcn/62.2.434 · DOI
  70. Filteau, 1994, Lack of association between vitamin A status and measures of conjunctival epithelial integrity in young children in northern Ghana, European Journal of Clinical Nutrition, 48, 669
  71. Ross, 1993, Vitamin A supplementation in northern Ghana: effects on clinic attendances, hospital admissions, and child mortality, Lancet, 342, 7, 10.1016/0140-6736(93)91879-Q · DOI
  72. Kirkwood, 1996, Effect of vitamin A supplementation on the growth of young children in northern Ghana, American Journal of Clinical Nutrition, 63, 773, 10.1093/ajcn/63.5.773 · DOI
  73. Kirkwood, 1996, Effect of vitamin A supplementation on the growth of young children in northern Ghana, Early Human Development, 46, 279, 10.1016/0378-3782(96)88188-6 · DOI
  74. Ross, 1995, Child morbidity and mortality following vitamin A supplementation in Ghana: time since dosing, number of doses, and time of year, American Journal of Public Health, 85, 1246, 10.2105/AJPH.85.9.1246 · DOI
  75. Benn, 2009, Does vitamin A supplementation interact with routine vaccinations? An analysis of the Ghana Vitamin A Supplementation Trial, American Journal of Clinical Nutrition, 90, 629, 10.3945/ajcn.2009.27477 · DOI
  76. Binka, 1995, Vitamin A supplementation and childhood malaria in northern Ghana, American Journal of Clinical Nutrition, 61, 853, 10.1093/ajcn/61.4.853 · DOI
  77. Dollimore, 1997, Measles incidence, case fatality, and delayed mortality in children with or without vitamin A supplementation in rural Ghana, American Journal of Epidemiology, 146, 646, 10.1093/oxfordjournals.aje.a009330 · DOI
  78. Filteau, 1995, Vitamin A supplementation, morbidity, and serum acute-phase proteins in young Ghanaian children, American Journal of Clinical Nutrition, 62, 434, 10.1093/ajcn/62.2.434 · DOI
  79. Filteau, 1994, Lack of association between vitamin A status and measures of conjunctival epithelial integrity in young children in northern Ghana, European Journal of Clinical Nutrition, 48, 669
  80. Ross, 1993, Vitamin A supplementation in northern Ghana: effects on clinic attendances, hospital admissions, and child mortality, Lancet, 342, 7, 10.1016/0140-6736(93)91879-Q · DOI
  81. Kirkwood, 1996, Effect of vitamin A supplementation on the growth of young children in northern Ghana, American Journal of Clinical Nutrition, 63, 773, 10.1093/ajcn/63.5.773 · DOI
  82. Kirkwood, 1996, Effect of vitamin A supplementation on the growth of young children in northern Ghana, Early Human Development, 46, 279, 10.1016/0378-3782(96)88188-6 · DOI
  83. Ross, 1995, Child morbidity and mortality following vitamin A supplementation in Ghana: time since dosing, number of doses, and time of year, American Journal of Public Health, 85, 1246, 10.2105/AJPH.85.9.1246 · DOI
  84. Semba, 1992, Impact of vitamin A supplementation on hematological indicators of iron metabolism and protein status in children, Nutrition Research, 12, 469, 10.1016/S0271-5317(05)80017-X · DOI
  85. Semba, 1994, Effect of vitamin A supplementation on immunoglobulin G subclass responses to tetanus toxoid in children, Clinical and Diagnostic Laboratory Immunology, 1, 172, 10.1128/cdli.1.2.172-175.1994 · DOI
  86. Semba, 1992, Depressed immune response to tetanus in children with vitamin A deficiency, Journal of Nutrition, 122, 101, 10.1093/jn/122.1.101 · DOI
  87. Semba, 1995, Reduced seroconversion to measles in infants given vitamin A with measles vaccination, Lancet, 345, 1330, 10.1016/S0140-6736(95)92536-8 · DOI
  88. Sempértegui, 1999, The beneficial effects of weekly low-dose vitamin A supplementation on acute lower respiratory infections and diarrhea in Ecuadorian children, Pediatrics, 104, e1, 10.1542/peds.104.1.e1 · DOI
  89. Shankar, 1999, Effect of vitamin A supplementation on morbidity due to Plasmodium falciparum in young children in Papua New Guinea: a randomised trial, Lancet, 354, 203, 10.1016/S0140-6736(98)08293-2 · DOI
  90. Sinha, 1976, The effect of massive doses of vitamin A on the signs of vitamin A deficiency in preschool children, American Journal of Clinical Nutrition, 29, 110, 10.1093/ajcn/29.1.110 · DOI
  91. Smith, 1999, Vitamin A and zinc supplementation of preschool children, Journal of the American College of Nutrition, 18, 213, 10.1080/07315724.1999.10718854 · DOI
  92. Abdeljaber, 1991, The impact of vitamin A supplementation on morbidity: a randomized community intervention trial, American Journal of Public Health, 81, 1654, 10.2105/AJPH.81.12.1654 · DOI
  93. Djunaedi, 1988, Impact of vitamin A supplementation on xerophthalmia. A randomized controlled community trial, Archives of Ophthalmology, 106, 218, 10.1001/archopht.1988.01060130228033 · DOI
  94. Schmitz, 2012, Vitamin A supplementation in preschool children and risk of hearing loss as adolescents and young adults in rural Nepal: randomised trial cohort follow-up study, BMJ, 344, d7962, 10.1136/bmj.d7962 · DOI
  95. Sommer, 1986, Impact of vitamin A supplementation on childhood mortality. A randomised controlled community trial, Lancet, 1, 1169, 10.1016/S0140-6736(86)91157-8 · DOI
  96. Tielsch JM West KP Jr Cost and efficiency considerations in community-based trials of vitamin A in developing countries Statistics in Medicine 1990 35-41; discussion 41-3 · DOI
  97. West KP Jr Djunaedi E Pandji A Vitamin A supplementation and growth: a randomized community trial American Journal of Clinical Nutrition 1988 1257 64 · DOI
  98. Stabell, 1995, No evidence of fontanelle-bulging episodes after vitamin A supplementation of 6- and 9-month-old infants in Guinea Bissau, European Journal of Clinical Nutrition, 49, 73
  99. Stansfield, 1993, Vitamin A supplementation and increased prevalence of childhood diarrhoea and acute respiratory infections, Lancet, 342, 578, 10.1016/0140-6736(93)91410-N · DOI
  100. Agtmaal, 1988, The effect of vitamin A supplementation on tear fluid retinol levels of marginally nourished preschool children, Current Eye Research, 7, 43, 10.3109/02713688809047018 · DOI
  101. Vijayaraghavan, 1990, Effect of massive dose vitamin A on morbidity and mortality in Indian children, Lancet, 336, 1342, 10.1016/0140-6736(90)92895-O · DOI
  102. Bishai, 2005, The impact of vitamin A supplementation on mortality inequalities among children in Nepal, Health Policy and Planning, 20, 60, 10.1093/heapol/czi007 · DOI
  103. Katz, 1995, Impact of vitamin A supplementation on prevalence and incidence of xerophthalmia in Nepal, Investigative Ophthalmology and Visual Science, 36, 2577
  104. Pokhrel, 1994, Sustained reduction in child mortality with vitamin A in Nepal, Lancet, 343, 1368, 10.1016/S0140-6736(94)92508-9 · DOI
  105. Shih JH Lu SE Analysis of failure time data with multilevel clustering, with application to the child vitamin a intervention trial in Nepal Biometrics 2007 673 80 · DOI
  106. West, 1991, Efficacy of vitamin A in reducing preschool child mortality in Nepal, Lancet, 338, 67, 10.1016/0140-6736(91)90070-6 · DOI
  107. West, 1997, Effects of vitamin A on growth of vitamin A-deficient children: field studies in Nepal, Journal of Nutrition, 127, 1957, 10.1093/jn/127.10.1957 · DOI
  108. Al-Mekhlafi, 2014, Effects of vitamin A supplementation on iron status indices and iron deficiency anaemia: a randomized controlled trial, Nutrients, 6, 190, 10.3390/nu6010190 · DOI
  109. Al-Mekhlafi, 2014, Does vitamin A supplementation protect schoolchildren from acquiring soil-transmitted helminthiasis? A randomized controlled trial, Parasites & Vectors, 7, 367, 10.1186/1756-3305-7-367 · DOI
  110. Bahl R Bhandari N Taneja S Bhan MK The impact of vitamin A supplementation on physical growth of children is dependent on season European Journal of Clinical Nutrition 1997 26 9 · DOI
  111. Bhaskaram, 1997, Enhancement in seroconversion to measles vaccine with simultaneous administration of vitamin A in 9-months-old Indian infants, Indian Journal of Pediatrics, 64, 503, 10.1007/BF02737757 · DOI
  112. Bloem, 1990, Vitamin A intervention: short-term effects of a single, oral, massive dose on iron metabolism, American Journal of Clinical Nutrition, 51, 76, 10.1093/ajcn/51.1.76 · DOI
  113. Chen, 2008, Effects of vitamin A, vitamin A plus iron and multiple micronutrient-fortified seasoning powder on preschool children in a suburb of Chongqing, China, Journal of Nutritional Science and Vitaminology, 54, 440, 10.3177/jnsv.54.440 · DOI
  114. Chen, 2011, Effects of vitamin A, vitamin A plus iron and multiple micronutrient-fortified seasoning powder on iron metabolic homeostasis, Chinese Journal of Pediatrics, 49, 926
  115. Chen, 2012, Effects of vitamin A, vitamin A plus zinc, and multiple micronutrients on anemia in preschool children in Chongqing, China, Asia Pacific Journal of Clinical Nutrition, 21, 3
  116. Chhagan, 2010, Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months, BMC Public Health, 10, 145, 10.1186/1471-2458-10-145 · DOI
  117. Chhagan, 2009, Effect of micronutrient supplementation on diarrhoeal disease among stunted children in rural South Africa, European Journal of Clinical Nutrition, 63, 850, 10.1038/ejcn.2008.78 · DOI
  118. Edmond, 2012, Effect of vitamin A supplementation in women of reproductive age on cause-specific early and late infant mortality in rural Ghana: ObaapaVitA double-blind, cluster-randomised, placebo-controlled trial, BMJ Open, 2, 1, 10.1136/bmjopen-2011-000658 · DOI
  119. Fahmida, 2007, Zinc-iron, but not zinc-alone supplementation, increased linear growth of stunted infants with low haemoglobin, Asia Pacific Journal of Clinical Nutrition, 16, 301
  120. Gannon, 2014, Biofortified orange maize is as efficacious as a vitamin A supplement in Zambian children even in the presence of high liver reserves of vitamin A: a community-based, randomized placebo-controlled trial, American Journal of Clinical Nutrition, 100, 1541, 10.3945/ajcn.114.087379 · DOI
  121. Kartasurya, 2012, Zinc combined with vitamin A reduces upper respiratory tract infection morbidity in a randomised trial in preschool children in Indonesia, British Journal of Nutrition, 108, 2251, 10.1017/S0007114512000499 · DOI
  122. Kothari, 1991, The effect of vitamin A prophylaxis on morbidity and mortality among children in urban slums in Bombay, Journal of Tropical Pediatrics, 37, 141, 10.1093/tropej/37.3.141 · DOI
  123. Nankabirwa V Tylleskar T Nankunda J Engebretsen I Sommerfelt H Tumwine J Poster presentation: prevalence of malaria parasitaemia among infants in Uganda and its association with breastfeeding, peer counselling and vitamin a supplementation Tropical Medicine & International Health. Abstracts of the 7th European Congress on Tropical Medicine and International Health; 2011 October 3-6; Barcelona, Spain 2011 97 · DOI
  124. Nankabirwa, 2011, Malaria parasitaemia among infants and its association with breastfeeding peer counselling and vitamin A supplementation: a secondary analysis of a cluster randomized trial, PLOS ONE, 6, e21862, 10.1371/journal.pone.0021862 · DOI
  125. Owusu-Agyei, 2013, Impact of vitamin A with zinc supplementation on malaria morbidity in Ghana, Nutrition Journal, 12, 1, 10.1186/1475-2891-12-131 · DOI
  126. Semba, 1990, Response of Bitot's spots in preschool children to vitamin A treatment, American Journal of Ophthalmology, 110, 416, 10.1016/S0002-9394(14)77024-2 · DOI
  127. Semba, 2005, Effect of periodic vitamin A supplementation on mortality and morbidity of human immunodeficiency virus-infected children in Uganda: a controlled clinical trial, Nutrition, 21, 25, 10.1016/j.nut.2004.10.004 · DOI
  128. Wu, 2007, Impact of vitamin A on the immune function of infants, China Tropical Medicine, 7, 540
  129. Yakymenko, 2011, The impact of different doses of vitamin A supplementation on male and female mortality. A randomised trial from Guinea-Bissau, BMC Pediatrics, 11, 77, 10.1186/1471-2431-11-77 · DOI
  130. Yang, 2002, Effect of micronutrient supplementation on the growth of preschool children in China, Biomedical and Environmental Sciences, 15, 196
  131. Aklamati, 2006, Impact of high-dose vitamin A supplements on vitamin A status of 3-4 year old Zambian boys, FASEB Journal, 20, A1050, 10.1096/fasebj.20.5.A1050 · DOI
  132. Alvarez, 1995, Urinary excretion of retinol in children with acute diarrhoea, American Journal of Clinical Nutrition, 61, 1273, 10.1093/ajcn/61.6.1273 · DOI
  133. Bates, 1995, Vitamin A, Lancet, 345, 31, 10.1016/S0140-6736(95)91157-X · DOI
  134. Bello, 2009, Routine vitamin A supplementation for the prevention of blindness due to measles infection in children, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD007719 · DOI
  135. Bhutta, 2015, Premature abandonment of global vitamin A supplementation programmes is not prudent!, International Journal of Epidemiology, 44, 297, 10.1093/ije/dyu274 · DOI
  136. Chen, 2008, Vitamin A for preventing acute lower respiratory tract infections in children up to seven years of age, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD006090.pub2 · DOI
  137. Darlow, 2011, Vitamin A supplementation to prevent mortality and short- and long-term morbidity in very low birthweight infants, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD000501.pub3 · DOI
  138. Fawzi, 1993, Vitamin A supplementation and child mortality, JAMA, 269, 898, 10.1001/jama.1993.03500070078033 · DOI
  139. Fawzi, 2006, The benefits and concerns related to vitamin a supplementation, Journal of Infectious Diseases, 193, 756, 10.1086/500369 · DOI
  140. Glasziou, 1993, Vitamin A supplementation in infectious diseases: a meta-analysis, BMJ, 306, 366, 10.1136/bmj.306.6874.366 · DOI
  141. Gogia, 2011, Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age or less, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD007480 · DOI
  142. Green, 1928, Vitamin A as an anti-infective agent, British Medical Journal, 2, 691, 10.1136/bmj.2.3537.691 · DOI
  143. Habicht, 2013, Vitamin A supplementation in Indian children, Lancet, 382, 592, 10.1016/S0140-6736(13)61736-5 · DOI
  144. Haider BA Sharma R Bhutta ZA Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in low and middle income countries Cochrane Database Syst Rev 10.1002/14651858.CD006980 · DOI
  145. Haskell, 1999, Maternal vitamin A nutriture and the vitamin A content of human milk, Journal of Mammary Gland Biology and Neoplasia, 4, 243, 10.1023/A:1018745812512 · DOI
  146. Hathcock, 1997, Vitamins and minerals: efficacy and safety, American Journal of Clinical Nutrition, 66, 427, 10.1093/ajcn/66.2.427 · DOI
  147. Higgins JPT Altman DG Sterne JAC Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011 Available from handbook.cochrane.org
  148. Higgins JPT Deeks JJ Altman DG Chapter 16: Special topics in statistics. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011 Available from handbook.cochrane.org
  149. Imdad, 2010, Preventive and therapeutic effects of vitamin A supplementation on infant and childhood morbidity and mortality: a systematic review, 1, 125
  150. Imdad, 2016, Vitamin A supplementation for the prevention of morbidity and mortality in infants one to six months of age, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD007480.pub3 · DOI
  151. Irlam, 2010, Micronutrient supplementation in children and adults with HIV infection, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD003650.pub3 · DOI
  152. Katz, 1995, Impact of vitamin A supplementation on prevalence and incidence of xerophthalmia in Nepal, Investigative Ophthalmology and Visual Science, 36, 2577
  153. Klemm RD West KJ Tielsh J Wu L Katz J TU54 poster presentation: pooled analysis of Asian newborn vitamin A supplementation trials to assess differential effects of early infant mortality Micronutrients, Health and Development: Evidence-based Programs. Proceedings of the 2nd International Meeting of the Micronutrient Forum; 2009 May 12-15; Beijing, China 2009 · DOI
  154. Klemm, 2010, Vitamin A fortification of wheat flour: considerations and current recommendations, Food and Nutrition Bulletin, 31, S47, 10.1177/15648265100311S105 · DOI
  155. Klemm, 2016, A changing landscape for vitamin A programs: implications for optimal intervention packages, program monitoring, and safety, Food and Nutrition Bulletin, 22, 1, 10.1177/0379572116630481 · DOI
  156. Mannar, 2013, Vitamin A supplementation in Indian children, Lancet, 382, 591, 10.1016/S0140-6736(13)61735-3 · DOI
  157. Mayo-Wilson, 2007, Reporting implementation in randomized trials: proposed additions to the consolidated standards of reporting trials statement, American Journal of Public Health, 97, 630, 10.2105/AJPH.2006.094169 · DOI
  158. Mayo-Wilson, 2011, Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis, BMJ, 343, d5094, 10.1136/bmj.d5094 · DOI
  159. Mayo-Wilson, 2013, Vitamin A supplementation in Indian children, Lancet, 382, 594, 10.1016/S0140-6736(13)61739-0 · DOI
  160. Mitra, 1998, Urinary retinol excretion and kidney function in children with shigellosis, American Journal of Clinical Nutrition, 68, 1095, 10.1093/ajcn/68.5.1095 · DOI
  161. Wu, 2005, Vitamin A for non-measles pneumonia in children, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD003700.pub2 · DOI
  162. Peto, 2013, Vitamin A supplementation in Indian children - authors' reply, Lancet, 382, 594, 10.1016/S0140-6736(13)61741-9 · DOI
  163. Ramakrishnan, 2002, Assessment and control of vitamin A deficiency disorders, Journal of Nutrition, 132, 2947, 10.1093/jn/132.9.2947S · DOI
  164. The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan) 2014
  165. Rice, 2004, Vitamin A Deficiency, 1
  166. Semba, 1999, Vitamin A and immunity to viral, bacterial and protozoan infections, Proceedings of the Nutrition Society, 58, 719, 10.1017/S0029665199000944 · DOI
  167. Shenai, 1993, Vitamin A, 87
  168. Sloan, 2013, Vitamin A supplementation in Indian children, Lancet, 382, 593, 10.1016/S0140-6736(13)61738-9 · DOI
  169. Smith, 1976, Vitamin A transport in human vitamin A toxicity, New England Journal of Medicine, 294, 805, 10.1056/NEJM197604082941503 · DOI
  170. Sommer, 1996, Vitamin A Deficiency: Health, Survival and Vision, 10.1093/oso/9780195088243.001.0001 · DOI
  171. Sommer, 2002, Assessment and control of vitamin A deficiency: the Annecy Accords, Journal of Nutrition, 132, 2845S, 10.1093/jn/132.9.2845S · DOI
  172. Sommer, 2013, Vitamin A supplementation in Indian children, Lancet, 382, 591, 10.1016/S0140-6736(13)60645-5 · DOI
  173. Stevens, 2015, Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys, Lancet Global Health, 3, e528-36, 10.1016/S2214-109X(15)00039-X · DOI · Paper page
  174. Food, 2000, Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc
  175. Broek, 2002, Vitamin A supplementation during pregnancy, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD001996 · DOI
  176. Lieshout, 2005, Vitamin A equivalency estimates: understanding apparent differences, American Journal of Clinical Nutrition, 81, 943-5; author r
  177. Villamor E Fawzi WW Vitamin A supplementation: implications for morbidity and mortality in children Journal of Infectious Diseases 2000 S122 33 10.1086/315921 · DOI
  178. West, 2002, Consequences of revised estimates of carotenoid bioefficacy for dietary control of vitamin A deficiency in developing countries, Journal of Nutrition, 132, 2920, 10.1093/jn/132.9.2920S · DOI
  179. West, 2003, Vitamin A deficiency disorders in children and women, Food and Nutrition Bulletin, 4, S78, 10.1177/15648265030244S104 · DOI · Paper page
  180. Wiysonge, 2011, Vitamin A supplementation for reducing the risk of mother-to-child transmission of HIV infection, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD003648.pub3 · DOI
  181. Yang, 2005, Vitamin A for treating measles in children, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD001479.pub3 · DOI
  182. Imdad, 2010, Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD008524.pub2 · DOI
  183. Imdad, 2010, Vitamin A supplementation for preventing morbidity and mortality in children six months to five years of age, Cochrane Database of Systematic Reviews, 10.1002/14651858.CD008524 · DOI

Cited by

Sorted by citations

Metadata

Authors
Imdad, A., Mayo-Wilson, E., Herzer, K., & Bhutta, Z. A.
Affiliations
  • Vanderbilt University (US)
  • Johns Hopkins University Bloomberg School of Public Health; Department of Epidemiology; 615 North Wolfe Street Baltimore Maryland USA 21205
  • Johns Hopkins University (US)
  • Hospital for Sick Children (CA)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2017-03-10
Volume
2017
Issue
11
Pages
CD008524-CD008524
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd008524.pub3
PMC
PMC6464706
OpenAlex
W2148456251
Cited by
513
References
0
Citations by year
2026: 8 · 2025: 29 · 2024: 40 · 2023: 52 · 2022: 60 · 2021: 61 · 2020: 61 · 2019: 33 · 2018: 32 · 2017: 23
FWCI
4.19
Type
journal article
Language
en
Update notices
new_version (2022-03-16)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
World Health Organization
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Vitamin D Research Studies
Keywords
vitamin A supplementation, vitamin A deficiency, children under five, child mortality, morbidity prevention, all-cause mortality, adverse effects, low- and middle-income countries, WHO guidelines
MeSH terms
Cause of Death, Child, Preschool, Diarrhea, Humans, Infant, Measles, Meningitis, Night Blindness, Respiration Disorders, Respiratory Tract Infections, Vitamin A, Vitamin A Deficiency, Vitamins, Vomiting, Randomized Controlled Trials as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review