Mortality Benefits of Vitamin A Are Not Affected by Varying Frequency, Total Dose, or Duration of Supplementation.
Food Nutr Bull
; 38(2): 260-266, 2017 06.
Article
em En
| MEDLINE
| ID: mdl-28513263
ABSTRACT
BACKGROUND:
Although vitamin A supplementation reduces child mortality, it remains unclear whether dosing frequency, total dose, or duration modifies effectiveness.OBJECTIVE:
Determine whether mortality effects of vitamin A vary by dosing frequency, total dose, or duration.METHODS:
Meta-analysis of randomized controlled trials, identified by systematic review and expert opinion, utilizing relatively standard World Health Organization doses in children <5 years. Meta-regression evaluated whether mortality effects varied by dosing frequency, total dose, or supplementation duration.RESULTS:
Identified 17 trials, including 1,180,718 children, mean (standard deviation [SD]) age 31.5 (15.4) months at baseline. Supplementation frequency ranged every 3 months-every 2 years, supplementation duration 4-60 months (mean = 15.4; SD = 12.8), and total dose 134,361-2,200,000 IU (mean = 667,132 IU; SD = 540,795). Compared with control, vitamin A reduced mortality 22% (95% confidence interval [CI] = 10-32; P = 0.002). This protective effect was not modified by increasing supplementation frequency (dose/year relative risk [RR] = 1.02; 95% CI = 0.98-1.06; P = .22), total dose (per 200,000 IU RR = 1.02; 95% CI = 0.97-1.06; P = .31), nor supplementation duration (per year RR = 1.06; 95% CI = 0.97-1.15; P = 0.14). Multivariate meta-regression showed similar results. Sensitivity analyses excluding 1 controversial trial (Aswathi 2013) did not alter findings.CONCLUSION:
Results confirm benefits of vitamin A supplementation in children <5 years in nations with vitamin A deficiency, without influence of frequency, total dose, or dosing duration within ranges evaluated. These findings inform design and efficiency of vitamin A supplementation policies.
Texto completo:
1
Eixos temáticos:
Pesquisa_clinica
Base de dados:
MEDLINE
Assunto principal:
Vitamina A
/
Deficiência de Vitamina A
/
Fenômenos Fisiológicos da Nutrição Infantil
/
Saúde Global
/
Medicina Baseada em Evidências
/
Suplementos Nutricionais
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Systematic_reviews
Limite:
Child, preschool
/
Humans
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article