What is the relationship between measles and vitamin A (Vitamin A) supplementation?

From the Guidelines

Vitamin A supplementation is strongly recommended for all children with measles, as it significantly reduces mortality, prevents eye damage, and shortens the duration and severity of diarrhea and respiratory infections associated with measles. The standard regimen is two doses of vitamin A: 200,000 IU for children 12 months and older (100,000 IU for 6-11 months, 50,000 IU for under 6 months), with the first dose given immediately upon diagnosis and the second dose the following day, as suggested by studies such as 1. This supplementation is crucial because measles depletes vitamin A stores and increases the risk of complications. Vitamin A strengthens the immune response, helps maintain epithelial tissue integrity, and promotes healing of damaged mucous membranes.

Some key points to consider when administering vitamin A supplementation to children with measles include:

• The dosage and frequency of vitamin A supplementation, with 200,000 IU for children 12 months and older, and 100,000 IU for children less than 12 months of age, as recommended by 1
• The importance of administering vitamin A supplementation immediately upon diagnosis, and repeating the dose the following day, as suggested by 1
• The benefits of vitamin A supplementation in reducing mortality, preventing eye damage, and shortening the duration and severity of diarrhea and respiratory infections associated with measles, as supported by studies such as 1

Healthcare providers should administer vitamin A as part of standard measles treatment, regardless of the child's nutritional status or geographic location, as it is a crucial component of comprehensive care for children with measles, and can significantly improve outcomes in terms of morbidity, mortality, and quality of life.

From the Research

Relationship Between Measles and Vitamin A Supplementation

The relationship between measles and vitamin A supplementation has been extensively studied, with research indicating that vitamin A deficiency is a recognized risk factor for severe measles infections 2, 3, 4, 5.

• Vitamin A supplementation has been shown to reduce mortality and complications resulting from measles, particularly in children under the age of two years 2, 3, 4.
• The World Health Organization (WHO) recommends administration of an oral dose of 200,000 IU of vitamin A per day for two days to children with measles in areas where vitamin A deficiency may be present 2, 4.
• Studies have found that two doses of 200,000 IU of vitamin A are associated with a reduction in the risk of mortality and pneumonia-specific mortality in children with measles 2, 3, 4.
• A single dose of 200,000 IU of vitamin A has not been shown to be associated with a reduced risk of mortality among children with measles 2, 3, 4.
• Vitamin A supplementation has also been found to reduce the incidence of croup and otitis media in children with measles 4.
• High-dose vitamin A therapy (400,000 IU) has been demonstrated to markedly reduce measles-associated morbidity and mortality in hospitalized children 6.

Dosage and Formulation

• The optimal dosage and formulation of vitamin A supplementation for the treatment of measles is still a topic of research, with studies suggesting that two doses of 200,000 IU of vitamin A may be more effective than a single dose 2, 3, 4.
• Water-based vitamin A formulations may be associated with a greater reduction in mortality than oil-based formulations 4.
• The effectiveness of vitamin A supplementation may be influenced by factors such as age, dose, formulation, hospitalization, and case fatality in the study area 2, 3, 4.