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Single dose vitamin A treatment in acute shigellosis in Bangladeshi children: randomised double blind controlled trial

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7129.422 (Published 07 February 1998) Cite this as: BMJ 1998;316:422

This article has a correction. Please see:

  1. Shahadat Hossain, senior medical officer (shossain{at}icddrb.org)a,
  2. Rabi Biswas, research assistanta,
  3. Iqbal Kabir, scientista,
  4. Shafique Sarker, associate scientista,
  5. Michael Dibley, senior lecturerb,
  6. George Fuchs, directora,
  7. Dilip Mahalanabis, former directora
  1. a Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box 128, Dhaka 1000, Bangladesh
  2. b Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW 2300, Australia
  1. Correspondence to: Dr Hossain
  • Accepted 3 October 1997

Abstract

Objective: To evaluate the efficacy of a single large oral dose of vitamin A in treating acute shigellosis in children in Bangladesh.

Design: Randomised double blind controlled clinical trial.

Setting: Dhaka Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh.

Subjects: 83 children aged 1–7 years with bacteriologically proved shigellosis but no clinical signs of vitamin A deficiency; 42 were randomised to treatment with vitamin A and 41 formed a control group.

Intervention: Children were given a single oral dose of 200 000 IU of vitamin A plus 25 IU vitamin E or a control preparation of 25 IU vitamin E.

Main outcome measures: Clinical cure on study day 5 and bacteriological cure.

Results: Baseline characteristics of the subjects in the two treatment groups were similar. Significantly more children in the vitamin A group than in the control group achieved clinical cure (19/42 (45%) v 8/14 (20%); χ2=5.14, 1 df, P=0.02; risk ratio=0.68 (95% confidence interval: 0.50 to 0.93)). When cure was determined bacteriologically, the groups had similar rates (16/42 (38%) v 16/41 (39%); χ2=0.02, 1 df, P=0.89; risk ratio=0.98 (0.70 to 1.39)).

Conclusions: Vitamin A reduces the severity of acute shigellosis in children living in areas where vitamin A deficiency is a major public health problem.

Key messages

  • A single oral dose of 200 000 IU vitamin A acts as an adjunct in the treatment of acute shigellosis among the children in geographical areas where vitamin A deficiency is a major public health problem

  • Vitamin A supplementation hastens clinical cure in acute shigellosis

  • Vitamin A supplementation during acute shigellosis has no effect on bacteriological clearance

  • Vitamin A may reduce the severity of acute shigellosis by promoting repair of the colonic mucosa and stimulating the immune system

Footnotes

  • Accepted 3 October 1997
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