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标题：Lessons Learned from the Testing of Neonatal Vitamin A Supplementation
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作者：Christine Stabell Benn ; Peter Aaby ; Ane Bærent Fisker 等
期刊名称：Nutrients
电子版ISSN：2072-6643
出版年度：2019
卷号：11
期号：2
页码：449-458
DOI：10.3390/nu11020449
出版社：MDPI Publishing
摘要：A total of 12 trials have tested the effect of neonatal vitamin A supplementation (NVAS) on mortality. Overall, NVAS had no effect on mortality, but results were heterogeneous. Two competing hypotheses have been put forward to explain the divergent effects: A) NVAS works by preventing vitamin A deficiency (VAD) and not all countries have VAD; B) NVAS interacts negatively with subsequent diphtheria-tetanus-pertussis (DTP) vaccine, increasing mortality in females; in countries with low DTP coverage NVAS may have a beneficial effect. Only hypothesis A was tested in a recent meta-analysis; there is no strong empirical support for hypothesis A and it would not explain observed negative effects in some settings. Hypothesis B accounts for most observations. However, so far it has only been tested properly in a few trials. If hypothesis B is correct, it has major consequences for the understanding of the effects of vitamin A, and for the VAS policy in older children. As a WHO priority, the DTP coverage is bound to increase, and therefore hypothesis B urgently needs to be tested.
关键词：neonatal vitamin A supplementation; diphtheria-tetanus-pertussis vaccine; infant mortality; low-income countries; vitamin A deficiency neonatal vitamin A supplementation ; diphtheria-tetanus-pertussis vaccine ; infant mortality ; low-income countries ; vitamin A deficiency