The evidence that supplemental vitamin A supplementation in children saves lives and prevents diseases is convincing enough to consider further placebo studies unethical, and support supplemental vitamin A intake for all children in low- and middle-income countries, according to a new meta-analysis, Published in the online edition of the British Medical Journal on August 25.

The analysis included 43 randomized trials with a total of 215,633 children aged 6 months to 5 years. Authors from the UK and Pakistan excluded studies with children with current illness, or hospitalized, or with food fortification or beta-carotene.

The results of 17 studies with 194,483 participants showed a 24% reduction in mortality from all causes (score ratio 0.76). Seven studies demonstrated a 28% reduction in mortality associated with diarrhea (score ratio 0.72).

Vitamin A supplementation was also associated with a decrease in the prevalence of diarrhea (the ratio of 0.85 estimates) and measles (0.50 ratio), and a decrease in the likelihood of vision problems, including night blindness (0.32) and xerophthalmia (0, 31).

Three studies reported an increased risk of vomiting within the first 48 hours after supplemental intake of vitamin A (a ratio of 2.75 estimates).

"Comparing with previous reviews, a meta-analysis shows that supplementation of vitamin A is associated with large and important reductions in mortality among children in low- and middle-income countries," write the authors.

The World Health Organization estimates that as many as 190 million children under 5 years of age may have a global vitamin A deficiency. Since vitamin A usually comes with food, countries with food problems can benefit most.

Reducing the number of deaths by 24% in 190 million children who have vitamin A deficiency can correspond to more than 600,000 lives saved each year, the researchers note..

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