The effect of high-dose vitamin A supplementation given with bacille Calmette-Guérin vaccine at birth on infant rotavirus infection and diarrhea: a randomized prospective study from Guinea-Bissau

TY - JOUR

T1 - The effect of high-dose vitamin A supplementation given with bacille Calmette-Guérin vaccine at birth on infant rotavirus infection and diarrhea: a randomized prospective study from Guinea-Bissau

AU - Diness, Birgitte Rode

AU - Christoffersen, Dorthe

AU - Pedersen, Ulla Britt

AU - Rodrigues, Amabelia

AU - Fischer, Thea Kølsen

AU - Andersen, Andreas

AU - Whittle, Hilton

AU - Yazdanbakhsh, Maria

AU - Aaby, Peter

AU - Benn, Christine Stabell

PY - 2010/9/1

Y1 - 2010/9/1

N2 - Background. Prophylactic vitamin A supplementation (VAS) reduces mortality and may reduce morbidity associated with diarrhea in children >6 months of age. Rotavirus is the most common cause of acute dehydrating diarrhea among children worldwide. Methods. In a randomized placebo-controlled study of 50,000 IU of vitamin A versus placebo given with bacille Calmette-Guérin vaccine at birth, 287 infants were followed up with weekly interviews and stool sample obtainment to test the hypothesis that VAS reduced the risk of rotavirus infection. Results. VAS was associated with increased risk of rotavirus infection and diarrhea (incidence rate ratio [IRR] of infection, 1.72 [95% confidence interval (CI), 1.04-2.85]; IRR of diarrhea, 3.74 [95% CI, 1.40-9.98]) among children <6 months of age. There was no effect in older children. VAS had a beneficial effect on nonrotavirus diarrhea in boys <6 months of age (IRR, 0.51; 95% CI, 0.27-0.95) and a detrimental effect in girls >6 months of age (IRR, 1.84; 95% CI, 0.96-3.55). Conclusion. VAS at birth did not reduce rotavirus morbidity. The effect of VAS on nonrotavirus diarrhea may differ by sex, being more beneficial in boys.

AB - Background. Prophylactic vitamin A supplementation (VAS) reduces mortality and may reduce morbidity associated with diarrhea in children >6 months of age. Rotavirus is the most common cause of acute dehydrating diarrhea among children worldwide. Methods. In a randomized placebo-controlled study of 50,000 IU of vitamin A versus placebo given with bacille Calmette-Guérin vaccine at birth, 287 infants were followed up with weekly interviews and stool sample obtainment to test the hypothesis that VAS reduced the risk of rotavirus infection. Results. VAS was associated with increased risk of rotavirus infection and diarrhea (incidence rate ratio [IRR] of infection, 1.72 [95% confidence interval (CI), 1.04-2.85]; IRR of diarrhea, 3.74 [95% CI, 1.40-9.98]) among children <6 months of age. There was no effect in older children. VAS had a beneficial effect on nonrotavirus diarrhea in boys <6 months of age (IRR, 0.51; 95% CI, 0.27-0.95) and a detrimental effect in girls >6 months of age (IRR, 1.84; 95% CI, 0.96-3.55). Conclusion. VAS at birth did not reduce rotavirus morbidity. The effect of VAS on nonrotavirus diarrhea may differ by sex, being more beneficial in boys.

KW - Age Factors

KW - BCG Vaccine

KW - Diarrhea

KW - Disease Outbreaks

KW - Female

KW - Guinea-Bissau

KW - Humans

KW - Incidence

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Rotavirus Infections

KW - Sex Factors

KW - Vitamin A

KW - Vitamins

U2 - 10.1086/653569

DO - 10.1086/653569

M3 - Journal article

C2 - 20684711

SN - 0022-1899

VL - 202 Suppl

SP - S243-51

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

ER -