A single oral dose of vitamin A given to infants
shortly after birth in the developing world can
reduce their risk of death by 15 percent, according to a
study conducted by researchers at the Johns
Hopkins Bloomberg School of Public Health. The study is
published in the July edition of the journal
Pediatrics.
"It has long been known that vitamin A supplementation
can reduce mortality in children over 6
months of age. Our study showed that vitamin A given at
birth can also improve infant survival within
the first 6 months of life," said Rolf D.W. Klemm, the
study's lead author and a researcher with the
Bloomberg School's Center for Human
Nutrition.
The study enrolled 15,937 newborns from rural
communities in northwest Bangladesh, where
more than 90 percent of babies are born at home. Half were
randomly selected to receive a 50,000
IU dose of vitamin A, while the other half received a
placebo. A 200,000 IU dose of vitamin A is
recommended semi-annually for older children. The vitamin A
was given orally to the infants within a
few days of birth, usually by seven hours after delivery.
The mortality rate for the vitamin A group
was 38.5 deaths per 1,000 births compared to 45.1 deaths
per 1,000 births for the nonŠvitamin A
group.
Although vitamin A reduced infant deaths from all
causes, lives were likely saved by reducing
the severity of potentially fatal infections, which are
responsible for most deaths in early infancy in
South Asia.
"This study supports the findings of previous vitamin
A studies in Southern Asia, where the
evidence is now strong that vitamin A given to newborns can
dramatically reduce mortality," said study
co-author Keith West, the George G. Graham Professor in
Infant and Child Nutrition at the Bloomberg
School. "More studies are urgently needed to determine if
newborn vitamin A supplementation would
reduce mortality among infants in other regions, especially
Africa."
Kent R. Hill, assistant administrator for Global
Health at the U.S. Agency for International
Development, said, "We are excited by the results of this
study that build on two previous studies in
South Asia, confirming this low-cost intervention can
significantly contribute to reducing mortality in
the first six months of life. A key next step," he said,
"is to consider the operational issues for using
this intervention." In conjunction with other partners,
USAID is conducting operations research in
Nepal and Bangladesh to determine possible approaches for
delivering vitamin A to newborn infants.
In the 1980s, Alfred Sommer demonstrated that vitamin
A deficiency dramatically increased
the risk of child mortality. Sommer, along with West and
colleagues from Johns Hopkins, further
demonstrated that a single dose of vitamin A given twice a
year, could reduce child mortality by 34
percent. The control of vitamin A deficiency is a global
goal of the World Health Organization and is
considered one of the most cost-effective of all health
interventions for saving young lives.
"Because childhood mortality is greatest during the
first few months of life, a single dose of
vitamin A administered by mouth to a newborn child can save
the lives of an additional 300,000
children in Asia every year," said Sommer, professor and
dean emeritus of the Bloomberg School.
"That is on top of the 1 million lives a year that would be
saved by dosing all vitamin A-deficient
children twice a year from 6 months through 5 years of
age."
The research was supported by grants from USAID and
the Bill and Melinda Gates Foundation.
Additional support was provided by the Sight and Life
Research Institute, Nutrilite Health
Institute, Canadian International Development Agency, and
National Integrated Population and Health
Program of the Ministry of Health and Family Welfare of the
government of the People's Republic of
Bangladesh.
The study was written by Klemm, Alain B. Labrique,
Parul Christian, Mahbubur Rashid, Abu
Ahmed Shamin, Joanne Katz, Sommer and West.
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