VITAMIN-A SUPPLEMENTATION AND SEVERITY OF PNEUMONIA IN CHILDREN ADMITTED TO THE HOSPITAL IN DAR-ES-SALAAM, TANZANIA

Vitamin A deficiency and acute lower respiratory tract infections coex ist as important public health problems in many developing countries. We carried out a randomized, double-blind, placebo-controlled trial to examine whether large doses of vitamin A given to Tanzanian children who are admitted to the hospital with nonmeasles pneumonia would reduc e the severity of respiratory disease. Six hundred eighty-seven childr en were randomly assigned to receive either placebo or vitamin A [200 000 IU (60 mg retinol equivalents) for children > 1 y of age and 100 0 00 IU (30 mg retinol equivalents) for infants] on the day of admission and another dose on the following day. Of the 346 children in the vit amin A group, 13 died in the hospital, compared with 8 of 341 children in the placebo group; the relative mortality was 1.63 (95% CI: 0.67, 3.97; P = 0.28). The mean number of days of hospitalization was the sa me in both groups (4.2 d). There were no differences between the vitam in A and placebo groups in the duration of hospital stay when examined within categories of children stratified by age, sex, breast-feeding status, nutritional status at baseline, or quartile of dietary vitamin A intake in the 4 mo before admission to the hospital. There were als o no differences in the mean number of days of fever, rapid respirator y rate, or hypoxia, whether these endpoints were examined in the total number of subjects or in a subset with more severe clinical condition s at baseline. Large doses of vitamin A had no protective effect on th e course of pneumonia in hospitalized Tanzanian children.