Vitamin A For Decreasing Mortality In Children With Measles : A Meta-analysis

Objective: To estimate whether vitamin A supplements is beneficial in decreasing mortality in children with measles.Methods : Research literatures related to vitamin A for treating measles in children were systematically retrieved from China National Knowledge Infrastructure(CNKI), Wanfang Database, Pubmed and Cochrane Library,which were published from January 1980 to December 2015. Keywords used were Vitamin A,VA, Retinol, Carotenoid, Retinoic acid, Retinoid, measles, randomized, controlled trial, controlled clinical trial, randomized, controlled, trial, random, placebo and its Chinese characters. Using Stata12.0 statistical software(using the fixed effects model) to conduct included studies for the meta-analysis to estimate the overall mortality in children with measles. Subgroups analyses were conducted by dose, formulation, age and pneumonia-specific mortality.Results: There were 5 randomized controlled trials considered for the meta-analysis. There was no significant reduction of mortality in the vitamin A-treated group(RR 0.63; 95% CI0.37- 1.08). Using vitamin A(200,000 IU/day) for two days or more than two days was associated with a reduction in mortality in children at the age of two years or less(RR 0.21; 95% CI0.07- 0.63)and a reduction of pneumonia-specific mortality(RR 0.35; 95% CI0.14- 0.90). There was no significant reduction mortality when using vitamin A in a single dose among children with measles(RR 1.25 95% CI0.54-2.90). There was no significant reduction mortality when using vitamin A(200,000 IU/day) for two days or more than two days in children more than two years( RR 0.94 95% CI0.33-2.70). Using water-based vitamin A was associated with a reduction in mortality among children with measles(RR 0.23 95% CI0.06-0.88). Using oil-based vitamin A was not associated with a reduction in mortality among children with measles(RR 0.85 95% CI0.46-1.56).Conclusion: There was no significant reduction of overall mortality with vitamin A therapy for children with measles, but there was evidence that vitamin A(200,000 IU/day) for two days or more than two days associated with a reduced mortality and pneumonia-specific mortality in children at the age of two years or less.