Vitamin a supplementation of vitamin a deficient measles patients lowers the risk of measles-related pneumonia in zambian children
Rosales, F.J.
Journal of Nutrition 132(12): 3700-3703
2002
ISSN/ISBN: 0022-3166 PMID: 12468610 DOI: 10.1093/jn/132.12.3700Document Number: 247221
This is an a posteriori analysis of previously published data to assess whether improving vitamin A (VA) status resolves measles-related pneumonia (MP). Nonhospitalized acute measles patients (2 d of rash onset) had their VA status determined based on the molar ratio of retinol-binding protein to transthyretin (RBP/TTR). Using a cutoff value of <=0.36, indicative of marginal VA deficiency, 82 children were diagnosed as marginally VA deficient and 114 were diagnosed as VA sufficient. At baseline, marginally VA-deficient patients had significantly lower serum retinol and higher serum C-reactive protein concentrations than VA-sufficient children. At the 2-wk follow-up visit, serum retinol and the RBP/TTR ratio were significantly greater in marginally VA-deficient measles patients receiving VA supplements than in those receiving placebo; whereas in VA-sufficient measles patients, retinol increased in those receiving VA supplements or placebo. Concomitantly the odds ratio of unresolved pneumonia in marginally VA-deficient measles patients receiving VA supplements compared with those receiving placebo was 0.20 (95% confidence interval, 0.05-0.71). In conclusion, VA supplements during measles infection improved VA status of VA-deficient children and helped resolve MP, demonstrating the importance of determining VA status when assessing the efficacy of VA supplements.