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American Journal of Clinical Nutrition, Vol. 82, No. 5, 1090-1096, November 2005
© 2005 American Society for Clinical Nutrition

ORIGINAL RESEARCH COMMUNICATION

Effects of moderate doses of vitamin A as an adjunct to the treatment of pneumonia in underweight and normal-weight children: a randomized, double-blind, placebo-controlled trial1,2,3,4

Alicia Rodríguez, Davidson H Hamer, José Rivera, Mario Acosta, Gilda Salgado, Martha Gordillo, Myryam Cabezas, Carlos Naranjo-Pinto, Julio Leguísamo, Dinor Gómez, Guillermo Fuenmayor, Edgar Játiva, Gladys Guamán, Bertha Estrella and Fernando Sempértegui

1 From the Corporación Ecuatoriana de Biotecnología, Quito, Ecuador (AR, BE, and FS); the Instituto de Ciencia y Tecnología, Ministerio de Salud Pública, Quito, Ecuador (AR and GG); the Center for International Health and Development, Boston University School of Public Health, Boston, MA (DHH); the Tufts University Gerald J and Dorothy R Friedman School of Nutrition Science and Policy, Medford, MA (DHH); the Universidad Central del Ecuador, Escuela de Medicina, Quito, Ecuador (JR, BE, and FS); and the Hospital de Niños Baca Ortiz, Quito, Ecuador (MA, GS, MG, MC, CN-P, JL, DG, GF, and EJ)

Background: Randomized controlled trials have shown inconsistent responses of childhood pneumonia to the use of vitamin A as an adjunct to the standard treatment of pneumonia.

Objective: We evaluated the effect of a moderate dose of vitamin A as an adjunct to standard antimicrobial treatment on the duration of respiratory signs in children with pneumonia.

Design: Children, aged 2–59 mo, with pneumonia and weight-for-age <50th percentile who had been admitted to the Baca Ortíz Children's Hospital in Quito, Ecuador, were randomly assigned to receive 50 000 IU (aged 2–12 mo) or 100 000 IU (aged >12–59 mo) vitamin A or a placebo.

Results: Of the 287 children enrolled, 145 received vitamin A and 142 received placebo. No overall differences were observed between the 2 groups in the duration of signs of pneumonia. Multiple linear regression showed a significant interaction between basal serum retinol concentration and vitamin A group for the time (in h) to remission of respiratory signs (ß = –3.57, SE = 1.09, P = 0.001). Duration of clinical signs was less in children with basal serum retinol concentrations >200 µg/L who received vitamin A supplements than in children with similar concentrations who received placebo (69.9 ± 49.9 h compared with 131.3 ± 143.9 h; P = 0.049).

Conclusions: Overall, we found no effect of a moderate dose of vitamin A supplementation on the duration of uncomplicated pneumonia in underweight or normal-weight children aged <5 y. However, a beneficial effect was seen in children with high basal serum retinol concentrations.

Key Words: Vitamin A • pneumonia • underweight • normal-weight • children • duration of signs of pneumonia






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