Routine vitamin A supplementation for the prevention of blindness due to measles infection in children

UPDATED

Segun Bello1, Martin M Meremikwu2, Regina I Ejemot-Nwadiaro3, Olabisi Oduwole4

1. Righospitalet, The Nordic Cochrane Centre, Copenhagen, Denmark
2. University of Calabar Teaching Hospital, Department of Paediatrics, Calabar, Cross River State, Nigeria
3. University of Calabar, Department of Public Health, College of Medical Sciences, Calabar, Cross River State, Nigeria
4. University of Calabar Teaching Hospital (ITDR/P), Institute of Tropical Diseases Research and Prevention, Calabar, Cross River State, Nigeria

Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O. Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD007719. doi/10.1002/14651858.CD007719.pub4/

To access the full-text article, please click here: DOI: 10.1002/14651858.CD007719.pub4/full

Vitamin A for preventing blindness in children with measles

Background

Annually 500,000 children become blind worldwide; 75% of them live in low-income countries. The major causes of blindness in children vary widely from region to region and are related to the standard of living of the community. Scarring of the eyes from measles, vitamin A deficiency, use of harmful traditional eye remedies and eye infection of the newborn, are the major causes of blindness in low-income countries. Vitamin A is an important nutrient in the body and is required for the normal functioning of the eye. Its deficiency results in poor vision.

Measles infection in children has been associated with vitamin A deficiency and blindness. The control of blindness in children is considered a high priority within the World Health Organization's VISION 2020 The Right to Sight Program. Studies have reported the beneficial effect of vitamin A in reducing disease burden and rate of death in children with measles. This review examined vitamin A use in preventing blindness in children infected with measles without features of vitamin A deficiency.

Study characteristics

We included two randomised controlled trials of moderate quality, including 260 children with measles, comparing children given vitamin A with children not given vitamin A.

Key results

The evidence is current to December 2015. Two doses of vitamin A given on two consecutive days to hospitalised children with measles led to an increase in the blood concentration of vitamin A after one week. However, there is a limitation in that neither of the two included studies reported blindness or other eye problems in children infected with measles. Also, no side effects of the treatment were reported in the included studies. We do not have sufficient evidence to demonstrate the benefit or otherwise of vitamin A in the prevention of blindness in children infected with measles.

Quality of evidence

The quality of the evidence and methodology of both studies was moderate. The sample size of the included studies was relatively small, which could affect the accuracy of the results.