Lessons Learned from the Testing of Neonatal Vitamin A Supplementation.
Nutrients
; 11(2)2019 Feb 21.
Article
en En
| MEDLINE
| ID: mdl-30795563
ABSTRACT
A total of 12 trials have tested the effect of neonatal vitamin A supplementation (NVAS) on mortality. Overall, NVAS had no effect on mortality, but results were heterogeneous. Two competing hypotheses have been put forward to explain the divergent effects A) NVAS works by preventing vitamin A deficiency (VAD) and not all countries have VAD; B) NVAS interacts negatively with subsequent diphtheria-tetanus-pertussis (DTP) vaccine, increasing mortality in females; in countries with low DTP coverage NVAS may have a beneficial effect. Only hypothesis A was tested in a recent meta-analysis; there is no strong empirical support for hypothesis A and it would not explain observed negative effects in some settings. Hypothesis B accounts for most observations. However, so far it has only been tested properly in a few trials. If hypothesis B is correct, it has major consequences for the understanding of the effects of vitamin A, and for the VAS policy in older children. As a WHO priority, the DTP coverage is bound to increase, and therefore hypothesis B urgently needs to be tested.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Atención Posnatal
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Vitamina A
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Deficiencia de Vitamina A
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Vitaminas
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Vacuna contra Difteria, Tétanos y Tos Ferina
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Suplementos Dietéticos
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Interacciones Farmacológicas
Tipo de estudio:
Systematic_reviews
Idioma:
En
Revista:
Nutrients
Año:
2019
Tipo del documento:
Article
País de afiliación:
Dinamarca