Single dose vitamin A treatment in acute shigellosis in Bangladeshi children: randomised double blind controlled trial
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. Subject...
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Published in | BMJ Vol. 316; no. 7129; pp. 422 - 426 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
London
British Medical Journal Publishing Group
07.02.1998
British Medical Association BMJ Publishing Group LTD BMJ Publishing Group |
Edition | International edition |
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Abstract | 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 |
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AbstractList | 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%); chi 2 = 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%); chi 2 = 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. 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 1â[euro]"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%); Ï[double dagger]2 =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%); Ï[double dagger]2 =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 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 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 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. |
Author | Kabir, Iqbal Biswas, Rabi Dibley, Michael Sarker, Shafique Hossain, Shahadat Mahalanabis, Dilip Fuchs, George |
Author_xml | – sequence: 1 givenname: Shahadat surname: Hossain fullname: Hossain, Shahadat email: shossain@icddrb.org organization: a Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box , Dhaka , Bangladesh – sequence: 2 givenname: Rabi surname: Biswas fullname: Biswas, Rabi organization: a Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box , Dhaka , Bangladesh – sequence: 3 givenname: Iqbal surname: Kabir fullname: Kabir, Iqbal organization: a Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box , Dhaka , Bangladesh – sequence: 4 givenname: Shafique surname: Sarker fullname: Sarker, Shafique organization: a Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box , Dhaka , Bangladesh – sequence: 5 givenname: Michael surname: Dibley fullname: Dibley, Michael organization: b Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW , Australia – sequence: 6 givenname: George surname: Fuchs fullname: Fuchs, George organization: a Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box , Dhaka , Bangladesh – sequence: 7 givenname: Dilip surname: Mahalanabis fullname: Mahalanabis, Dilip organization: a Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box , Dhaka , Bangladesh |
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Keywords | Human Acute Single dose Adjuvant treatment Controlled therapeutic trial Shigellosis Retinol Infection Chemotherapy Bacteriosis Digestive diseases Bacteria Intestinal disease Child Shigella Enterobacteriaceae |
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Snippet | Abstract Objective: To evaluate the efficacy of a single large oral dose of vitamin A in treating acute shigellosis in children in Bangladesh. Design:... 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... 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... |
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SubjectTerms | Antibiotics Bacillary dysentery Bacteria Bacterial diseases Biological and medical sciences Child nutrition Childhood Children & youth Control groups Developing countries Diarrhea Disease Dosage Family medical history Hospitals Human bacterial diseases Infectious diseases LDCs Medical research Medical sciences Miscellaneous Morbidity Mortality Shigella Shigellosis Studies Tropical bacterial diseases Tropical medicine Viruses Vitamin A Vitamin A deficiency Vitamin E |
Title | Single dose vitamin A treatment in acute shigellosis in Bangladeshi children: randomised double blind controlled trial |
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