History of Vitamin A Supplementation Reduces Severity of Diarrhea in Young Children Admitted to Hospital with Diarrhea and Pneumonia

Mohammod J. Chisti, Mohammed A. Salam, Abu S. G. Faruque, Hasan Ashraf, Pradip K. Bardhan, Sumon K. Das, Sayeeda Huq, Fahmida Chowdhury, Shoeb B. Islam, Tahmeed Ahmed

Centre for Communicable Diseases (CCD), Dhaka, Bangladesh..
Centre for Nutrition & Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Centre for Nutrition & Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh&Clinical Services (CS), Dhaka, Bangladesh.
Centre for Nutrition & Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh&Clinical Services (CS), Dhaka, Bangladesh;.
Centre for Nutrition & Food Security (CNFS), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh;.
Clinical Services (CS), Dhaka, Bangladesh.
Clinical Services (CS), Dhaka, Bangladesh;.
Research Administration Services (RAS), Dhaka, Bangladesh;.

DOI: 10.4236/fns.2013.42021                

Abstract

Background: Although the role of vitamin A in childhood pneumonia in association with diarrhea is not fully proven, we did not find any published data demonstrating the impact of lack of vitamin A supplementation in under-five children who present with the co-morbidities of pneumonia and diarrhea. This study examined whether previous vitamin A supplementation was associated with reduced severity and duration of diarrhea and pneumonia for children presenting with both illnesses. Methods: All admitted children (n = 189) aged 0 - 59 months to the Special Care Ward of the Dhaka Hospital of icddr,b with diarrhea and radiological pneumonia from September-December 2007 were enrolled. We compared clinical features of the children who received (n = 96) and did not receive (n = 93) high potency capsule vitamin A supplementation during previous immunization according to EPI schedule. Results: In logistic regression analysis, after adjusting for potential confounders such as respiratory rate, lower chest wall in-drawing, severe wasting and systolic blood pressure, vitamin A non-supplemented children with pneumonia and diarrhea more often presented in their early infancy (95% CI 1.01 - 1.09), had duration of diarrhea for >4 days (95% CI 1.79 - 11.88), had clinical dehydration (95% CI 1.2 - 5.63), and more often required hospitalization for >7 days (95% CI 1.03 - 8.87). But, there was no significant difference in the clinical features of pneumonia, such as history of cough, respiratory rate, lower chest wall in-drawing, nasal flaring, head nodding, grunting respiration, cyanosis, and inability to drink between the groups. Conclusion: Lack of vitamin A supplementation in under-five children with radiological pneumonia and diarrhea is independently associated with young infancy, duration of diarrhea for >4 days, dehydration and hospitalization for >7 days which underscores the importance of routine supplementation of vitamin A in young infancy. However, lack of vitamin A supplementation did not influence any clinical signs of pneumonia.

Keywords

Bangladesh; Diarrhea; Children; Lower Chest Wall In-Drawing; Pneumonia; Vitamin A Supplementation

Conflicts of Interest

The authors declare no conflicts of interest.

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