IVACG: Policy Statement on Vitamin A, Diarrhea and Measles

Alnwick D, Arthur P, Davidson F, Horwitz A, Reddy V, Smitasiri S, Sommer A, Underwood B, West K
December 31, 1994

Abstract: Scientific evidence accumulated in the last decade has led to consensus about the protective role of vitamin A supplementation on childhood mortality. In populations where vitamin A deficiency is endemic, a 23-34% reduction in mortality is expected when vitamin A status is raised to normal values. Community trials achieved this impact within a brief (4-6-month) period through universal periodic supplementation in the form of either megadoses, small weekly doses, or vitamin A-fortified foods. This reduction was due in large part to a fall in diarrheal and measles-related deaths in the supplemented children. Clinical trials of children hospitalized with measles showed that large-dose vitamin A had a beneficial effect on mortality in previously deficient children, with case-fatality ratios reduced on average by 66%. In addition, there is growing evidence of the impact of improved vitamin A status in reducing the duration, severity, and complications associated with both measles and diarrhea. Given that diarrhea and measles are still leading causes of infant and childhood morbidity and mortality in developing countries, and considering the body of evidence, members of the International Vitamin A Consultative Group (IVACG) Steering Committee strongly recommend that vitamin A supplements be included in all child survival programs as an effective strategy to reduce the consequences of these diseases.

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