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History of Vitamin A Supplementation Reduces Severity of Diarrhea in Young Children Admitted to Hospital with Diarrhea and Pneumonia

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Food and Nutrition Sciences 2013年第2期4卷 150-155页

作者： Mohammod J. Chisti Mohammed A. Salam Abu S. G. Faruque Hasan Ashraf Pradip K. Bardhan Sumon K. Das Sayeeda Huq Fahmida Chowdhury Shoeb B. Islam Tahmeed Ahmed Centre for Communicable Diseases (CCD) Dhaka Bangladesh. Centre for Nutrition & Food Security (CNFS) International Centre for Diarrhoeal Disease Research Dhaka Bangladesh Centre for Nutrition & Food Security (CNFS) International Centre for Diarrhoeal Disease Research Dhaka Bangladesh&Clinical Services (CS) Dhaka Bangladesh Centre for Nutrition & Food Security (CNFS) International Centre for Diarrhoeal Disease Research Dhaka Bangladesh&Clinical Services (CS) Dhaka Bangladesh Centre for Nutrition & Food Security (CNFS) International Centre for Diarrhoeal Disease Research Dhaka Bangladesh Clinical Services (CS) Dhaka Bangladesh Clinical Services (CS) Dhaka Bangladesh Research Administration Services (RAS) Dhaka Bangladesh

Background: Although the role of vitamin A in childhood pneumonia in association with diarrhea is not fully proven, we did not find any published data demonstrating the impact of lack of vitamin A supplementation in under-five children who present with the co-morbidities of pneumonia and diarrhea. This study examined whether previous vitamin A supplementation was associated with reduced severity and duration of diarrhea and pneumonia for children presenting with both illnesses. Methods: All admitted children (n = 189) aged 0 - 59 months to the Special Care Ward of the Dhaka Hospital of icddr,b with diarrhea and radiological pneumonia from September-December 2007 were enrolled. We compared clinical features of the children who received (n = 96) and did not receive (n = 93) high potency capsule vitamin A supplementation during previous immunization according to EPI schedule. Results: In logistic regression analysis, after adjusting for potential confounders such as respiratory rate, lower chest wall in-drawing, severe wasting and systolic blood pressure, vitamin A non-supplemented children with pneumonia and diarrhea more often presented in their early infancy (95% CI 1.01 - 1.09), had duration of diarrhea for >4 days (95% CI 1.79 - 11.88), had clinical dehydration (95% CI 1.2 - 5.63), and more often required hospitalization for >7 days (95% CI 1.03 - 8.87). But, there was no significant difference in the clinical features of pneumonia, such as history of cough, respiratory rate, lower chest wall in-drawing, nasal flaring, head nodding, grunting respiration, cyanosis, and inability to drink between the groups. Conclusion: Lack of vitamin A supplementation in under-five children with radiological pneumonia and diarrhea is independently associated with young infancy, duration of diarrhea for >4 days, dehydration and hospitalization for >7 days which underscores the importance of routine supplementation of vitamin A in young infancy. However, lack of vitamin A supplement

关键词： Bangladesh Diarrhea Children Lower Chest Wall in-drawing Pneumonia Vitamin A Supplementation

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