Vitamin A supplementation and increased prevalence of childhood diarrhoea and acute respiratory infections

There is uncertainty over whether vitamin A supplementation reduces morbidity among children with subclinical deficiency of the vitamin. Hence a double‐blind, placebo‐controlled trial of the effect of vitamin A supplementation on childhood morbidity was conducted among 11,124 children aged 6‐83 months in the northwest of Haiti. After a random start, children were sequentially assigned by household units to receive either megadose vitamin A or placebo in three distribution cycles 4 months apart. 2 to 8 weeks after each administration of the vitamin A and placebo capsules, indicators of childhood morbidity were reassessed through interviews conducted in the homes of participating families. The vitamin A group was found to have an increased 2‐week prevalence of all symptoms and signs of childhood morbidity assessed, including diarrhoea (rate ratio [RR] = 1.09, 95% confidence interval 1.05‐1.14), rhinitis (RR = 1.02, 95% confidence interval 1.00‐1.04), cold/flu symptoms (RR = 1.04, 95% confidence interval 1.01‐1.06), cough (RR = 1.07, 95% confidence interval 1.03‐1.11), and rapid breathing (RR = 1.18, 95% confidence interval 1.09‐1.27). The study shows an increased 2‐week prevalence of diarrhoea and the symptoms of respiratory infections after vitamin A supplementation.