EFFICACY OF VITAMIN-A IN REDUCING PRESCHOOL-CHILD MORTALITY IN NEPAL
EFFICACY OF VITAMIN-A IN REDUCING PRESCHOOL-CHILD MORTALITY IN NEPAL
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DOI：
10.1016/0140-6736(91)90070-6
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发表时间：
1991-07-13
期刊：
影响因子：
168.9
通讯作者：
SOMMER, A
中科院分区：
文献类型：
--
作者：
WEST, KP;POKHREL, RP;SOMMER, A
关于补充维生素A降低学龄前儿童死亡率功效的社区试验产生了相互矛盾的结果。为了解决这个问题，在尼泊尔农村地区进行了一项随机、双盲、安慰剂对照的社区试验，共有28630名6-72个月大的儿童，这是南亚恒河冲积平原的一个代表性地区。按行政病房随机分组；补充维生素a的儿童每4个月服用60000当量视黄醇，而服用安慰剂的儿童服用含有300当量视黄醇的相同胶囊。12个月后，与对照组相比，补充维生素a组的相对死亡风险为0.70(95%可信区间0.56-0.88)，相当于死亡率降低了30%。原计划持续2年的试验被终止。男女（男孩的相对危险度为0.77；女孩的相对危险度为0.65）、所有年龄段（相对危险度范围为0.83-0.50）和全年（0.76-0.67）的死亡率均有所下降。死亡风险的降低不受急性营养状况（用臂围衡量）的影响。因此，在社区定期提供维生素A可以大大降低发展中国家的儿童死亡率。
Community trials of the efficacy of vitamin A supplementation in reducing preschool childhood mortality have produced conflicting results. To resolve the question, a randomised, double-masked, placebo-controlled community trial of 28 630 children aged 6-72 months was carried out in rural Nepal, an area representative of the Gangetic flood plain of South Asia. Randomisation was carried out by administrative ward; the vitamin-A-supplemented children received 60 000 retinol equivalents every 4 months and placebo-treated children received identical capsules containing 300 retinol equivalents. After 12 months, the relative risk of death in the vitamin-A-supplemented compared with the control group was 0.70 (95% confidence interval 0.56-0.88), equivalent to a 30% reduction in mortality. The trial, which had been planned to last 2 years, was discontinued. The reduction in mortality was present in both sexes (relative risk for boys 0.77; for girls 0.65), at all ages (range of relative risks 0.83-0.50), and throughout the year (0.76-0.67). The reduction in mortality risk was not affected by acute nutritional status, as measured by arm circumference. Thus, periodic vitamin A delivery in the community can greatly reduce child mortality in developing countries.