Giving vitamin A supplements to children below the age of five in low- and middle-income countries could significantly cut rates of mortality, illnesses and blindness among them, according to an international study. Researchers from University of Oxford and Aga Khan University Hospital (AKUH) have revealed in their research that vitamin A supplements reduce mortality among children in low- and middle-income countries by nearly a quarter or 24 percent.
The study, published in the British Medical Journal’s online version, states that the supplements were found to bring particular benefits in reducing incidence of diarrhoea and measles among the children.
Believing that the benefits are so clear that trials comparing vitamin A to placebo are no longer ethical, researchers from AKUH and Oxford University’s Centre for Evidence-Based Intervention are now calling for vitamin A supplements to be given to children at risk of not getting enough vitamins through their diets.
The findings are based a study comprising 43 trials in which some children were given vitamin A while others received no intervention or a placebo. The sample included 215,633 healthy children aged 6 months to 5 years in 19 countries, mostly in Asia. On an average, the children were 2.5 years old, when they were recruited for the trials that followed for about one year.
The lead author of the study is Dr Evan Mayo-Wilson from Oxford University’s Department of Social Policy and Intervention.
“Our study shows that, until other sources are available, [vitamin A] supplements should be given to all children who are at risk of its deficiency. After just one year, children who had taken supplements were less likely to have died than children who received a placebo. We estimate that by providing supplements to all children in countries where they are at risk, we could save up to 600,000 lives a year and prevent millions of serious infections. Vitamin A supplements are highly effective and cheap to produce and administer,” he said.
“The research also shows that systematic literature reviews are cost-effective and ethically imperative. Recent editorials criticising vitamin A programmes have received international attention, but the evidence taken as a whole leaves little doubt that vitamin A prevents early childhood mortality.
“The largest clinical trial ever conducted ran from 1999 to 2004 and assigned about 1 million children to receive vitamin A or placebo. Since that trial began, only one relatively small trial has examined vitamin A for childhood mortality,” he added.
Senior corresponding author of the study, Prof Zulfiqar Bhutta, the Head of the AKUH Division of Women and Child Health, said, “This study underlines the need to shift the focus of attention towards an effective scale up of vitamin A supplementation programmes. We must ensure that the benefits are sustained with effective oversight by national programmes.”
Vitamin A is required for normal functioning of visual and immune systems. It is an essential nutrient that cannot be synthesised by the human body and, therefore, must be obtained through diet. Deficiency increases vulnerability to a range of infections including diarrhoea, measles, malaria and respiratory infections, which are the leading causes of childhood mortality.
According to recent estimates by the World Health Organisation, 190 million children aged under five do not get enough vitamin A.
Vitamin A is found in plants, such as orange-fleshed sweet potatoes, eggs and dairy products. High intake of synthetic vitamin A over a long period may lead to short-term side effects including vomiting. However, side effects are rare and taking supplements of vitamin A over relatively short periods, for example, once every six months, should not cause serious adverse effects, according to the study.