Effect of vitamin A supplementation in women of reproductive age on cause-specific early and late infant mortality in rural Ghana: ObaapaVitA double-blind, cluster-randomised, placebo-controlled trial
Identifieur interne : 000733 ( Main/Exploration ); précédent : 000732; suivant : 000734Effect of vitamin A supplementation in women of reproductive age on cause-specific early and late infant mortality in rural Ghana: ObaapaVitA double-blind, cluster-randomised, placebo-controlled trial
Auteurs : Karen Edmond [Royaume-Uni] ; Lisa Hurt [Royaume-Uni] ; Justin Fenty [Royaume-Uni] ; Seeba Amenga-Etego [Ghana] ; Charles Zandoh [Ghana] ; Chris Hurt [Royaume-Uni] ; Samuel Danso [Ghana] ; Charlotte Tawiah [Ghana] ; Zelee Hill [Royaume-Uni] ; Augustinus H A. Ten Asbroek [Royaume-Uni] ; Seth Owusu-Agyei [Ghana] ; Oona Campbell [Royaume-Uni] ; Betty R. Kirkwood [Royaume-Uni]Source :
- BMJ Open [ 2044-6055 ] ; 2012.
Abstract
To assess the effect of vitamin A supplementation in women of reproductive age in Ghana on cause- and age-specific infant mortality. In addition, because of recently published studies from Guinea Bissau, effects on infant mortality by sex and season were assessed.
Double-blind, cluster-randomised, placebo-controlled trial.
7 contiguous districts in the Brong Ahafo region of Ghana.
All women of reproductive age (15–45 years) resident in the study area randomised by cluster of residence. All live born infants from 1 June 2003 to 30 September 2008 followed up through 4-weekly home visits.
Weekly low-dose (25 000 IU) vitamin A.
Early infant mortality (1–5 months); late infant mortality (6–11 months); infection-specific infant mortality (0–11 months).
1086 clusters, 62 662 live births, 52 574 infant-years and 3268 deaths yielded HRs (95% CIs) comparing weekly vitamin A with placebo: 1.04 (0.88 to 1.05) early infant mortality; 0.99 (0.84 to 1.18) late infant mortality; 1.03 (0.92 to 1.16) infection-specific infant mortality. There was no evidence of modification of the effect of vitamin A supplementation on infant mortality by sex (Wald statistic =0.07, p=0.80) or season (Wald statistic =0.03, p=0.86).
This is the largest analysis of cause of infant deaths from Africa to date. Weekly vitamin A supplementation in women of reproductive age has no beneficial or deleterious effect on the causes of infant death to age 6 or 12 months in rural Ghana.
Url:
DOI: 10.1136/bmjopen-2011-000658
PubMed: 22218721
PubMed Central: 3330261
Affiliations:
- Ghana, Royaume-Uni
- Angleterre, Grand Londres, Nottinghamshire
- Londres, Nottingham
- University College de Londres, Université de Nottingham
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Le document en format XML
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<author><name sortKey="Ten Asbroek, Augustinus H A" sort="Ten Asbroek, Augustinus H A" uniqKey="Ten Asbroek A" first="Augustinus H A" last="Ten Asbroek">Augustinus H A. Ten Asbroek</name>
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<author><name sortKey="Owusu Agyei, Seth" sort="Owusu Agyei, Seth" uniqKey="Owusu Agyei S" first="Seth" last="Owusu-Agyei">Seth Owusu-Agyei</name>
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<author><name sortKey="Campbell, Oona" sort="Campbell, Oona" uniqKey="Campbell O" first="Oona" last="Campbell">Oona Campbell</name>
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<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
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<author><name sortKey="Kirkwood, Betty R" sort="Kirkwood, Betty R" uniqKey="Kirkwood B" first="Betty R" last="Kirkwood">Betty R. Kirkwood</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Objectives</title>
<p>To assess the effect of vitamin A supplementation in women of reproductive age in Ghana on cause- and age-specific infant mortality. In addition, because of recently published studies from Guinea Bissau, effects on infant mortality by sex and season were assessed.</p>
</sec>
<sec><title>Design</title>
<p>Double-blind, cluster-randomised, placebo-controlled trial.</p>
</sec>
<sec><title>Setting</title>
<p>7 contiguous districts in the Brong Ahafo region of Ghana.</p>
</sec>
<sec><title>Participants</title>
<p>All women of reproductive age (15–45 years) resident in the study area randomised by cluster of residence. All live born infants from 1 June 2003 to 30 September 2008 followed up through 4-weekly home visits.</p>
</sec>
<sec><title>Intervention</title>
<p>Weekly low-dose (25 000 IU) vitamin A.</p>
</sec>
<sec><title>Main outcome measures</title>
<p>Early infant mortality (1–5 months); late infant mortality (6–11 months); infection-specific infant mortality (0–11 months).</p>
</sec>
<sec><title>Results</title>
<p>1086 clusters, 62 662 live births, 52 574 infant-years and 3268 deaths yielded HRs (95% CIs) comparing weekly vitamin A with placebo: 1.04 (0.88 to 1.05) early infant mortality; 0.99 (0.84 to 1.18) late infant mortality; 1.03 (0.92 to 1.16) infection-specific infant mortality. There was no evidence of modification of the effect of vitamin A supplementation on infant mortality by sex (Wald statistic =0.07, p=0.80) or season (Wald statistic =0.03, p=0.86).</p>
</sec>
<sec><title>Conclusions</title>
<p>This is the largest analysis of cause of infant deaths from Africa to date. Weekly vitamin A supplementation in women of reproductive age has no beneficial or deleterious effect on the causes of infant death to age 6 or 12 months in rural Ghana.</p>
</sec>
<sec><title>Trial registration number</title>
<p><ext-link ext-link-type="uri" xlink:href="http://ClinicalTrials.gov">http://ClinicalTrials.gov</ext-link>
: NCT00211341.</p>
</sec>
</div>
</front>
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<author><name sortKey="Humphrey, J" uniqKey="Humphrey J">J Humphrey</name>
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<author><name sortKey="Othman, M" uniqKey="Othman M">M Othman</name>
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<author><name sortKey="Black, Re" uniqKey="Black R">RE Black</name>
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</analytic>
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<author><name sortKey="Quigley, Ma" uniqKey="Quigley M">MA Quigley</name>
</author>
<author><name sortKey="Zandoh, C" uniqKey="Zandoh C">C Zandoh</name>
</author>
</analytic>
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</author>
<author><name sortKey="Armstrong Schellenberg, Jr" uniqKey="Armstrong Schellenberg J">JR Armstrong Schellenberg</name>
</author>
<author><name sortKey="Snow, Rw" uniqKey="Snow R">RW Snow</name>
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</analytic>
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</author>
<author><name sortKey="Khatry, Sk" uniqKey="Khatry S">SK Khatry</name>
</author>
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<author><name sortKey="Labrique, A" uniqKey="Labrique A">A Labrique</name>
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<author><name sortKey="Klemm, R" uniqKey="Klemm R">R Klemm</name>
</author>
</analytic>
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</author>
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</author>
<author><name sortKey="Christian, P" uniqKey="Christian P">P Christian</name>
</author>
</analytic>
</biblStruct>
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</author>
<author><name sortKey="Fisher, Dj" uniqKey="Fisher D">DJ Fisher</name>
</author>
<author><name sortKey="Osmond, C" uniqKey="Osmond C">C Osmond</name>
</author>
</analytic>
</biblStruct>
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</author>
<author><name sortKey="Jahari, Ab" uniqKey="Jahari A">AB Jahari</name>
</author>
<author><name sortKey="Sebayang, Sk" uniqKey="Sebayang S">SK Sebayang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Beaton, Gh" uniqKey="Beaton G">GH Beaton</name>
</author>
<author><name sortKey="L Abbe, Mr" uniqKey="L Abbe M">MR L'Abbé</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Stephensen, Cb" uniqKey="Stephensen C">CB Stephensen</name>
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</TEI>
<affiliations><list><country><li>Ghana</li>
<li>Royaume-Uni</li>
</country>
<region><li>Angleterre</li>
<li>Grand Londres</li>
<li>Nottinghamshire</li>
</region>
<settlement><li>Londres</li>
<li>Nottingham</li>
</settlement>
<orgName><li>University College de Londres</li>
<li>Université de Nottingham</li>
</orgName>
</list>
<tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Edmond, Karen" sort="Edmond, Karen" uniqKey="Edmond K" first="Karen" last="Edmond">Karen Edmond</name>
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<name sortKey="Campbell, Oona" sort="Campbell, Oona" uniqKey="Campbell O" first="Oona" last="Campbell">Oona Campbell</name>
<name sortKey="Fenty, Justin" sort="Fenty, Justin" uniqKey="Fenty J" first="Justin" last="Fenty">Justin Fenty</name>
<name sortKey="Hill, Zelee" sort="Hill, Zelee" uniqKey="Hill Z" first="Zelee" last="Hill">Zelee Hill</name>
<name sortKey="Hurt, Chris" sort="Hurt, Chris" uniqKey="Hurt C" first="Chris" last="Hurt">Chris Hurt</name>
<name sortKey="Hurt, Lisa" sort="Hurt, Lisa" uniqKey="Hurt L" first="Lisa" last="Hurt">Lisa Hurt</name>
<name sortKey="Kirkwood, Betty R" sort="Kirkwood, Betty R" uniqKey="Kirkwood B" first="Betty R" last="Kirkwood">Betty R. Kirkwood</name>
<name sortKey="Ten Asbroek, Augustinus H A" sort="Ten Asbroek, Augustinus H A" uniqKey="Ten Asbroek A" first="Augustinus H A" last="Ten Asbroek">Augustinus H A. Ten Asbroek</name>
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<country name="Ghana"><noRegion><name sortKey="Amenga Etego, Seeba" sort="Amenga Etego, Seeba" uniqKey="Amenga Etego S" first="Seeba" last="Amenga-Etego">Seeba Amenga-Etego</name>
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<name sortKey="Danso, Samuel" sort="Danso, Samuel" uniqKey="Danso S" first="Samuel" last="Danso">Samuel Danso</name>
<name sortKey="Owusu Agyei, Seth" sort="Owusu Agyei, Seth" uniqKey="Owusu Agyei S" first="Seth" last="Owusu-Agyei">Seth Owusu-Agyei</name>
<name sortKey="Tawiah, Charlotte" sort="Tawiah, Charlotte" uniqKey="Tawiah C" first="Charlotte" last="Tawiah">Charlotte Tawiah</name>
<name sortKey="Zandoh, Charles" sort="Zandoh, Charles" uniqKey="Zandoh C" first="Charles" last="Zandoh">Charles Zandoh</name>
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</record>
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