SINGLE-DOSE VITAMIN-A TREATMENT IN ACUTE SHIGELLOSIS IN BANGLADESHI CHILDREN - RANDOMIZED DOUBLE-BLIND CONTROLLED TRIAL

Objective: To evaluate the efficacy of a single large oral dose of vit amin A in treating acute shigellosis in children in Bangladesh. Design : Randomised double blind controlled clinical trial. Setting: Dhaka Ho spital, International Centre for Diarrhoeal Disease Research, Banglade sh. Subjects: 83 children aged 1-7 years with bacteriologically proved shigellosis but no clinical signs of vitamin A deficiency; 42 were ra ndomised to treatment with vitamin A and 41 formed a control group. In tervention: Children were given a single oral dose of 200 000 IU of vi tamin A plus 25 IU vitamin E or a control preparation of 25 IU vitamin E. Main outcome measures: Clinical cure on study day 5 and bacteriolo gical cure. Results: Baseline characteristics of the subjects in the t wo treatment groups were similar. Significantly more children in the v itamin A group than in the control group achieved clinical cure (19/42 (45%) v 8/14 (20%); chi(2)=5.14, 1 df, P=0.02; risk ratio=0.68 (95% c onfidence interval: 0.50 to 0.93)). When cure was determined bacteriol ogically, the groups had similar rates (16/42 (38%) v 16/41 (39%); chi (2)-0.02, 1 df, P=0.89; risk ratio=0.98 (0.70 to 1.39)). Conclusions: Vitamin a reduces the severity of acute shigellosis in children living in areas where vitamin A deficiency is a major public health problem.