Is Vitamin A effective for treating measles in children?

From the Guidelines

Vitamin A is effective for treating measles in children, and the recommended dosage is 200,000 IU for children older than 1 year and 100,000 IU for infants, with a second dose given the next day, as supported by the most recent and highest quality study 1.

Key Points

• Vitamin A supplementation has been shown to reduce mortality and prevent complications such as pneumonia and diarrhea in children with measles 1.
• The World Health Organization recommends vitamin A supplementation for all children diagnosed with measles, particularly in areas where vitamin A deficiency or measles case-fatality rates are high 1.
• Vitamin A works by helping maintain epithelial tissue integrity and immune function, which are compromised during measles infection 1.
• A study published in 2020 in the journal Clinical Nutrition highlights the importance of vitamin A supplementation in reducing morbidity and mortality in infectious diseases, including measles 1.

Dosage and Administration

• The recommended dosage of vitamin A for children with measles is 200,000 IU for children older than 1 year and 100,000 IU for infants, with a second dose given the next day 1.
• Children with complicated measles should receive a second dose of vitamin A on day 2 1.

Benefits of Vitamin A Supplementation

• Reduces mortality and prevents complications such as pneumonia and diarrhea in children with measles 1.
• Helps maintain epithelial tissue integrity and immune function, which are compromised during measles infection 1.
• Reduces morbidity and mortality in infectious diseases, including measles, diarrhea, and malaria 1.

From the Research

Effectiveness of Vitamin A in Treating Measles in Children

• Vitamin A has been shown to be effective in reducing mortality and complications in children with measles, particularly when given in two doses of 200,000 IU on consecutive days 2, 3, 4.
• The World Health Organization (WHO) recommends administration of an oral dose of 200,000 IU (or 100,000 IU in infants) of vitamin A per day for two days to children with measles in areas where vitamin A deficiency may be present 2, 3, 4.
• Studies have found a significant reduction in mortality in children under the age of two years who received two doses of vitamin A (200,000 IU) on consecutive days, with a relative risk (RR) of 0.18 (95% CI 0.03 to 0.61) 2, 3, 4.
• Vitamin A has also been shown to reduce the incidence of croup (RR 0.53; 95% CI 0.29 to 0.89) and pneumonia-specific mortality (RR 0.33; 95% CI 0.08 to 0.92) in children with measles 2, 3, 4.

Dosage and Formulation

• Two doses of water-based vitamin A were associated with a greater reduction in mortality (RR 0.19; 95% CI 0.02 to 0.85) compared to two doses of oil-based preparation (RR 0.52; 95% CI 0.16 to 1.40) 2, 3.
• A single dose of 200,000 IU of vitamin A was not associated with a significant reduction in mortality in children with measles (RR 0.77; 95% CI 0.34 to 1.78) 2, 3, 4.

Age and Nutritional Status

• The effect of vitamin A was greater in children under the age of two years, with a significant reduction in mortality (RR 0.18; 95% CI 0.03 to 0.61) and pneumonia-specific mortality (RR 0.33; 95% CI 0.08 to 0.92) 2, 3, 4.
• Mortality was several times higher in marasmic children compared to better-nourished children, regardless of vitamin A supplementation 5.

Clinical Trials and Studies

• A randomized clinical trial found that vitamin A supplements reduced mortality in children with measles, particularly in those under the age of two years (p < 0.05) 5.
• A retrospective study of hospital records found that high-dose vitamin A therapy (400,000 IU) was associated with a shorter hospital stay, lower requirement for intensive care, and lower death rate in children hospitalized with measles 6.