According to a study published on bmj.com today, children in low and middle-income countries should receive vitamin A supplements to prevent death and illness. Researchers believe further trials to be unethical as the effectiveness of vitamin A supplementation is extremely well documented and press the need to provide supplements for all children at risk of deficiency to policymakers.

Vitamin A, an essential nutrient for the body, must be obtained through diet. Deficiency in children means they are more vulnerable to infections like diarrhoea and measles and can also lead to blindness. The World Health Organization estimates that worldwide 190 million children below the age of 5 may suffer from a vitamin A deficiency, however, even though widespread efforts are made to provide the vital vitamin to children, the program does not reach all children who could benefit.

Researchers based in the UK and Pakistan therefore decided to analyze the results of the 43 vitamin A supplementation trials, taking into account study design and quality to minimize bias. The study involved more than 200,000 children between the ages of 6 months to 5 years.

They discovered, that administering vitamin A supplements to children reduced the mortality by 24% in low and middle-income countries. Additionally it also may reduce mortality and disability through preventing measles, diarrhoea and vision problems, including blindness.

The researchers calculated, that a reduced child mortality of 24% in 190 million children suffering from vitamin A deficiency would result in saving over 600,000 lives and gaining 20 million disability-adjusted life years (a measure of quantity and quality of life) and based on these results urge to supply children below the age of 5 in risk areas with vitamin A supplements. They conclude to say that evidence for vitamin A is compelling and clear and further trials comparing vitamin A with placebo would be unethical.

Their view is supported by two experts at Harvard School of Public Health in an accompanying editorial, who say “effort should now focus on finding ways to sustain this important child survival initiative and fine tune it to maximize the number of lives saved.”

Written by Petra Rattue