Routine vitamin A supplementation for the prevention of blindness due to measles infection in children
Annually 500,000 children become blind worldwide, 75% of them living in low-income countries. The major causes of blindness in children vary widely from region to region and are related to the standard of living of the community. Corneal scarring from measles, vitamin A deficiency, use of harmful traditional eye remedies and ophthalmia neonatorium (newborn conjunctivitis) are the major causes in low-income countries. Vitamin A is an important nutrient in the body and is required for the normal functioning of the eye. Its deficiency results in poor vision.
Measles infection in children has been associated with vitamin A deficiency and blindness. The control of blindness in children is considered a high priority within the World Health Organization's VISION 2020 The Right to Sight Program. Studies have reported the beneficial effect of vitamin A in reducing morbidity and mortality in children with measles. This review examined vitamin A use in preventing blindness in children infected with measles without features of vitamin A deficiency. We included two randomised controlled trials of moderate quality, including 260 children with measles comparing vitamin A with placebo. Two doses of vitamin A given on two consecutive days to hospitalised children with measles significantly increased the blood concentration of vitamin A after one week.
However, there is a limitation in that neither of the two included studies reported blindness or other ocular morbidities as end points in children infected with measles. The sample size of the included studies was also relatively small which could affect the precision of the estimates given. Also no adverse event was reported in the included studies. We do not have sufficient evidence to demonstrate the benefit or otherwise of vitamin A in the prevention of blindness in children infected with measles.
The evidence is current to March 2013.
Bello, S.; Meremikwu, M.M.; Ejemot-Nwadiaro, R.I.; Oduwole, O. Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. Cochrane Database of Systematic Reviews (2014) (Issue 1) Art. No.: CD007719. [DOI: 10.1002/14651858.CD007719.pub3]