FoodandNutritionSciences,2013,4,150-155http://dx.doi.org/10.4236/fns.2013.42021PublishedOnlineFebruary2013(http://www.scirp.org/journal/fns)HistoryofVitaminASupplementationReducesSeverityofDiarrheainYoungChildrenAdmittedtoHospitalwithDiarrheaandPneumoniaMohammodJ.Chisti1,2*,MohammedA.Salam3,AbuS.G.Faruque1,HasanAshraf1,2,PradipK.Bardhan2,SumonK.Das1,SayeedaHuq1,FahmidaChowdhury4,ShoebB.Islam2,TahmeedAhmed11CentreforNutrition&FoodSecurity(CNFS),InternationalCentreforDiarrhoealDiseaseResearch,Dhaka,Bangladesh;2ClinicalServices(CS),Dhaka,Bangladesh;3ResearchAdministrationServices(RAS),Dhaka,Bangladesh;4CentreforCommunicableDis-eases(CCD),Dhaka,Bangladesh.Email:*chisti@icddrb.orgReceivedDecember21st,2012;revisedJanuary21st,2013;acceptedJanuary30th,2013ABSTRACTBackground:AlthoughtheroleofvitaminAinchildhoodpneumoniainassociationwithdiarrheaisnotfullyproven,wedidnotfindanypublisheddatademonstratingtheimpactoflackofvitaminAsupplementationinunder-fivechil-drenwhopresentwiththeco-morbiditiesofpneumoniaanddiarrhea.ThisstudyexaminedwhetherpreviousvitaminAsupplementationwasassociatedwithreducedseverityanddurationofdiarrheaandpneumoniaforchildrenpresentingwithbothillnesses.Methods:Alladmittedchildren(n=189)aged0-59monthstotheSpecialCareWardoftheDhakaHospitaloficddr,bwithdiarrheaandradiologicalpneumoniafromSeptember-December2007wereenrolled.Wecomparedclinicalfeaturesofthechildrenwhoreceived(n=96)anddidnotreceive(n=93)highpotencycapsulevitaminAsupplementationduringpreviousimmunizationaccordingtoEPIschedule.Results:Inlogisticregressionanalysis,afteradjustingforpotentialconfounderssuchasrespiratoryrate,lowerchestwallin-drawing,severewastingandsystolicbloodpressure,vitaminAnon-supplementedchildrenwithpneumoniaanddiarrheamoreoftenpresentedintheirearlyinfancy(95%CI1.01-1.09),haddurationofdiarrheafor>4days(95%CI1.79-11.88),hadclinicalde-hydration(95%CI1.2-5.63),andmoreoftenrequiredhospitalizationfor>7days(95%CI1.03-8.87).But,therewasnosignificantdifferenceintheclinicalfeaturesofpneumonia,suchashistoryofcough,respiratoryrate,lowerchestwallin-drawing,nasalflaring,headnodding,gruntingrespiration,cyanosis,andinabilitytodrinkbetweenthegroups.Conclusion:LackofvitaminAsupplementationinunder-fivechildrenwithradiologicalpneumoniaanddiarrheaisindependentlyassociatedwithyounginfancy,durationofdiarrheafor>4days,dehydrationandhospitalizationfor>7dayswhichunderscorestheimportanceofroutinesupplementationofvitaminAinyounginfancy.However,lackofvitaminAsupplementationdidnotinfluenceanyclinicalsignsofpneumonia.Keywords:Bangladesh;Diarrhea;Children;LowerChestWallIn-Drawing;Pneumonia;VitaminASupplementation1.IntroductionPneumoniaanddiarrheaarethetwoleadingcausesofdeathandmorbidityinunder-fivechildrenindevelopingcountries[1,2].Amongtheestimated7.6millionglobaldeathsinunder-fivechildrenin2010,pneumoniaanddiarrheaaccountedfor18%and11%ofthedeathsre-spectively[3].Inmanydevelopingcountries,thesetwoarethecommonco-morbiditiesinunder-fivechildrenwithhighmorbidityanddeaths[4,5].SupplementationofcapsulevitaminAhasaprovenroleforthereductionoftheincidenceofdiarrhea[6-8]butitsroleinchildhoodpneumoniainassociationwithdiarrheaisnotfullyproven[9].Developmentofclinicalfeatures,especiallythedangersignsofpneumoniaandconsequencesofdi-arrheausuallydependsondiseaseseverity.VitaminAsupplementationoftenreducesdiseaseseverityanddeathsin...
