the impact of different doses of vitamin a supplementation on male and female mortality. a randomised trial from guinea-bissau不同剂量的维生素a补充的影响男性和女性的死亡率。.pdf

Yakymenko et al. BMC Pediatrics 2011, 11:77 /1471-2431/11/77 RESEARCH ARTICLE Open Access The impact of different doses of vitamin A supplementation on male and female mortality. A randomised trial from Guinea-Bissau 1,3* 1,2 1 1 1 1 Dorthe Yakymenko , Christine S Benn , Cesario Martins , Birgitte R Diness , Ane B Fisker , Amabelia Rodrigues and Peter Aaby1,2 Abstract Background: Vitamin A supplementation (VAS) given to children between 6 months and 5 years of age is known to reduce mortality in low-income countries. We have previously observed that girls benefit more from a lower dose of VAS than the one recommended by WHO, the effect being strongest if diphtheria-tetanus-pertussis vaccine (DTP) was the most recent vaccination. We aimed to test these observations. Methods: During national immunisations days in Guinea-Bissau, West Africa, combining oral polio vaccination and VAS, we randomised 8626 children between 6 months and 5 years of age to receive the dose of VAS recommended by WHO or half this dose. Mortality rate ratios (MRRs) were assessed after 6 and 12 month. Results: The overall mortality rate among participants was lower than expected. There was no significant difference in mortality at 6 months and 12 months of follow up between the low dose VAS group and the recommended dose VAS group. The MRRs were 1.23 (0.60-2.54) after 6 months and 1.17 (0.73-1.87) after 12 months. This tendency was similar in boys and girls. The low dose was not associated with lower mortality in girls if the most recent vaccine was DTP (MRR = 0.60 (0.14-2.50) after 6 months). Conclusion: Our sample size does not permit firm conclusions since mortality was lower than expected. We could not confir