Vitamin A does not improve clinical course nor reduce complications in children with measles

Supplementation with vitamin A does not lead to alterations in the clinical course of measles infection or the rate of complications in children hospitalized in a high-income country, a study has shown.

The authors performed a prospective controlled study involving 108 children (median age 16.3 months, 36 percent female) admitted for measles to a tertiary-care hospital in Southern Italy. Fever duration was the primary endpoint, while secondary ones included the length of hospitalization, complications rate, need for antibiotic treatment, and body temperature.

Of the patients, 36 received two doses of oil-based vitamin A according to age, and 72 matched controls received standard care.

No significant between-group differences were noted in fever duration (7.03±2.67 vs 6.82±3.27; p=0.72), hospitalization length (median, 5.0 vs 5.0 days; p=0.50), maximum body temperature (median, 39 °C in both groups; p=0.23), rate of organ (69.4 percent vs 63.9 percent; p=0.72) and haematologic complications (41.7 percent vs 59.7 percent; p=0.12), or need for antibiotic treatment (66.7 percent vs 61.1 percent; p=0.72).

Of note, vitamin A supplementation failed to reduce the risk of any complications (relative risk, 1.33, 95 percent confidence interval, 0.59–2.96).

“Worldwide medical authorities recommend vitamin A supplementation for severe measles requiring hospitalization; however, evidence supporting its use in high-income countries is lacking,” the authors said. “A nationwide vitamin A shortage reported in concomitance with a recent measles outbreak in Italy provided an opportunity to test the effectiveness of vitamin A in a high-income setting.”