OBJECTIVES: To determine whether a single high dose of vitamin A given to all children in communities with high mortality and malnutrition could affect mortality and to assess whether periodic community wide supplementation could be readily incorporated into an ongoing primary health programme. DESIGN: Opportunistic controlled trial. SETTING: Jumla district, Nepal. SUBJECTS:All children aged under 5 years; 3786 in eight subdistricts given single dose ofvitamin A and 3411 in remaining eight subdistricts given no supplementation. MAIN OUTCOME MEASURES: Mortality and cause of death in the five months after supplementation. RESULTS:Risk of death for children aged 1-59 months in supplemented communities was 26% lower (relative risk 0.74, 95% confidence interval 0.55 to 0.99) than in unsupplemented communities. The reduction in mortality was greatest among children aged 6-11 months: death rate (deaths/1000 child years at risk) was 133.8 in supplemented children and 260.8 in unsupplemented children (relative risk 0.51, 0.30 to 0.89). The death rate from diarrhoea was also reduced (63.5 supplemented v 97.5 unsupplemented; relative risk 0.65, 0.44 to 0.95). The extra cost per death averted was about $11. CONCLUSION: The results support a role for Vitamin A in increasing child survival. The supplementation programme was readily integrated with the ongoing community health programme at little extra cost.
RCT Entities:
OBJECTIVES: To determine whether a single high dose of vitamin A given to all children in communities with high mortality and malnutrition could affect mortality and to assess whether periodic community wide supplementation could be readily incorporated into an ongoing primary health programme. DESIGN: Opportunistic controlled trial. SETTING: Jumla district, Nepal. SUBJECTS: All children aged under 5 years; 3786 in eight subdistricts given single dose of vitamin A and 3411 in remaining eight subdistricts given no supplementation. MAIN OUTCOME MEASURES: Mortality and cause of death in the five months after supplementation. RESULTS: Risk of death for children aged 1-59 months in supplemented communities was 26% lower (relative risk 0.74, 95% confidence interval 0.55 to 0.99) than in unsupplemented communities. The reduction in mortality was greatest among children aged 6-11 months: death rate (deaths/1000 child years at risk) was 133.8 in supplemented children and 260.8 in unsupplemented children (relative risk 0.51, 0.30 to 0.89). The death rate from diarrhoea was also reduced (63.5 supplemented v 97.5 unsupplemented; relative risk 0.65, 0.44 to 0.95). The extra cost per death averted was about $11. CONCLUSION: The results support a role for Vitamin A in increasing child survival. The supplementation programme was readily integrated with the ongoing community health programme at little extra cost.
Entities:
Keywords:
Age Distribution; Age Factors; Asia; Biology; Causes Of Death; Child Mortality--changes; Child Survival--changes; Control Groups; Demographic Factors; Demographic Impact; Developing Countries; Diseases; Length Of Life; Malnutrition; Mortality; Nepal; Nutrition Disorders; Physiology; Population; Population At Risk; Population Characteristics; Population Dynamics; Research Methodology; Sex Distribution; Sex Factors; Southern Asia; Survivorship; Vitamin A--administraction and dosage; Vitamin A--beneficial effects; Vitamins
Authors: K P West; R P Pokhrel; J Katz; S C LeClerq; S K Khatry; S R Shrestha; E K Pradhan; J M Tielsch; M R Pandey; A Sommer Journal: Lancet Date: 1991-07-13 Impact factor: 79.321
Authors: Joanne Katz; Keith P West; Lee Wu; Subarna K Khatry; Elizabeth Kimbrough Pradhan; Parul Christian; Steven C LeClerq; Sharada Ram Shrestha Journal: Am J Public Health Date: 2002-07 Impact factor: 9.308