scholarly journals The effect of high-dose vitamin A supplementation at birth on measles incidence during the first 12 months of life in boys and girls: an unplanned study within a randomised trial

2011 ◽  
Vol 105 (12) ◽  
pp. 1819-1822 ◽  
Author(s):  
Birgitte R. Diness ◽  
Cesário L. Martins ◽  
Carlitos Balé ◽  
May-Lill Garly ◽  
Henrik Ravn ◽  
...  

Vitamin A treatment reduces mortality during acute measles infection, and vitamin A supplementation (VAS) to children above 6 months of age may reduce the incidence of measles infection. The effect of VAS at birth on measles incidence is unknown. In a randomised placebo-controlled trial in Guinea-Bissau, normal-birth-weight newborns were randomised to 50 000 IU (15 mg) VAS or placebo. During the trial, a measles epidemic occurred. We linked data from the trial with data from the measles infection surveillance and studied the effect of VAS on the measles incidence before 12 months of age in both sexes. A total of 165 measles cases were identified among the 4183 children followed from 28 d of age. Up to 6 months of age, the incidence rate ratio of measles for VAS compared with placebo was 0·54 (95 % CI 0·25, 1·15) among boys and 1·57 (95 % CI 0·80, 3·08) among girls (test of interaction, P = 0·04). The corresponding figures at 12 months were 0·67 (95 % CI 0·43, 1·05) and 1·17 (95 % CI 0·76, 1·79) (test of interaction, P = 0·08). VAS compared with placebo tended to be associated with less measles hospitalisation or death during the first 6 months of life in boys (P = 0·06), but not in girls. VAS at birth may affect the susceptibility to measles infection during the first 6 months of life in a sex-differential manner.

2007 ◽  
Vol 98 (2) ◽  
pp. 422-430 ◽  
Author(s):  
R. A. Ayah ◽  
D. L. Mwaniki ◽  
P. Magnussen ◽  
A. E. Tedstone ◽  
T. Marshall ◽  
...  

Postpartum vitamin A supplementation of mothers and infants is recommended, but the efficacy has been questioned. In this double-blind, placebo-controlled trial, Kenyan mother–infant pairs were randomised to maternal vitamin A (400 000 IU) or placebo < 24 h postpartum, and infant vitamin A (100 000 IU) or placebo at 14 weeks. Milk retinol was determined at weeks 4, 14 and 26, and maternal and infant serum retinol at weeks 14 and 26. Infant retinol stores were assessed at week 26, using a modified relative dose response (MRDR) test. Among 564 women, serum retinol at 36 weeks gestation was 0·81 (sd 0·21) μmol/l, and 33·3 % were < 0·7 μmol/l. Maternal serum retinol was not different between groups, but milk retinol was higher in the vitamin A group: (0·67 v. 0·60 μmol/l; 0·52 v. 0·44 μmol/l; 0·50 v. 0·44 μmol/l at 4, 14 and 26 weeks, respectively). When expressed per gram fat, milk retinol was higher in the vitamin A group only at 4 weeks. Infant serum retinol was not different between groups. However, although most infants had deficient vitamin A stores (MRDR>0·06 %) at 26 weeks, vitamin A to infants, but not mothers, resulted in a lower proportion of infants with deficient vitamin A stores (69 v. 78 %). High-dose postpartum vitamin A supplementation failed to increase serum retinol and infant stores, despite modest effects on milk retinol. Infant supplementation, however, increased stores. There is a need for a better understanding of factors affecting absorption and metabolism of vitamin A.


2007 ◽  
Vol 86 (4) ◽  
pp. 1152-1159 ◽  
Author(s):  
Birgitte R Diness ◽  
Ane B Fisker ◽  
Adam Roth ◽  
Maria Yazdanbakhsh ◽  
Erliyani Sartono ◽  
...  

Vaccine ◽  
2013 ◽  
Vol 31 (31) ◽  
pp. 3191-3198 ◽  
Author(s):  
Ane Bærent Fisker ◽  
Carlito Bale ◽  
Mathias Jul Jørgensen ◽  
Ibriama Balde ◽  
Linda Hornshøj ◽  
...  

1993 ◽  
Vol 123 (4) ◽  
pp. 666-675 ◽  
Author(s):  
Rebecca J. Stoltzfus ◽  
Mohammad Hakimi ◽  
Kevin W. Miller ◽  
Kathleen M. Rasmussen ◽  
Siti Dawiesah ◽  
...  

2012 ◽  
Vol 109 (3) ◽  
pp. 467-477 ◽  
Author(s):  
Mathias J. Jørgensen ◽  
Ane B. Fisker ◽  
Erliyani Sartono ◽  
Andreas Andersen ◽  
Christian Erikstrup ◽  
...  

Vitamin A supplementation (VAS) at birth was not associated with improved survival in a randomised, placebo-controlled trial in Guinea-Bissau. However, a negative sex-differential effect, which became evident after diphtheria–tetanus–pertussis (DTP) vaccination, was noted; among girls who had received DTP, VAS at birth was associated with two-fold higher mortality than placebo. The objective of the present study was to investigate the immunological effects of VAS at birth within a subgroup of participants in the randomised trial. Guided by the mortality results, we further explored whether VAS had a differential effect according to sex and DTP status. At 6 weeks after randomisation and supplementation, we measured differential leucocyte counts and TNF-α, interferon-γ, IL-10, IL-13 and IL-5 production in a whole-blood culture assay. A total of 471 children were included. VAS compared with placebo at birth was associated with a higher proportion of monocytes (relative risk ratio 1·26, 95 % CI 1·07, 1·49, P= 0·04), while spontaneous TNF-α production was lower in the VAS group (geometric mean ratio 0·54, 95 % CI, 0·37, 0·78, P= 0·001). Stratified analysis showed that VAS was associated with lower TNF-α and IL-10 production for girls without DTP and boys with DTP, resulting in significant three-way interactions between VAS, sex and DTP vaccination status (P= 0·03 and P= 0·04, respectively) for spontaneous TNF-α and IL-10 production. The results substantiate the potential role of VAS as an immunomodulatory intervention, which has different effects depending on concomitant health interventions and the sex of the recipient.


2019 ◽  
Vol 86 (6) ◽  
pp. 538-541 ◽  
Author(s):  
Ted Greiner ◽  
John Mason ◽  
Christine Stabell Benn ◽  
H. P. S. Sachdev

1997 ◽  
Vol 86 (10) ◽  
pp. 1052-1055 ◽  
Author(s):  
NV Si ◽  
C. Grytter ◽  
NNT Vy ◽  
NB Hue ◽  
FK Pedersen

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