Vitamin D3 Supplementation and Childhood Diarrhea: A Randomized Controlled Trial.


Aluisio, AR; Maroof, Z; Chandramohan, D; Bruce, J; Mughal, MZ; Bhutta, Z; Walraven, G; Masher, MI; Ensink, JH; Manaseki-Holland, S; (2013) Vitamin D3 Supplementation and Childhood Diarrhea: A Randomized Controlled Trial. Pediatrics, 132 (4). e832-e840. ISSN 0031-4005 DOI: https://doi.org/10.1542/peds.2012-3986

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Abstract

OBJECTIVE: To investigate the effect of vitamin D3 supplementation on the incidence and risk for first and recurrent diarrheal illnesses among children in Kabul, Afghanistan.<br/> METHODS: This double-blind placebo-controlled trial randomized 3046 high-risk 1- to 11-month-old infants to receive 6 quarterly doses of oral vitamin D3 (cholecalciferol 100 000 IU) or placebo in inner city Kabul. Data on diarrheal episodes (≥3 loose/liquid stools in 24 hours) was gathered through active and passive surveillance over 18 months of follow-up. Time to first diarrheal illness was analyzed by using Kaplan-Meier plots. Incidence rates and hazard ratios (HRs) were calculated by using recurrent event Poisson regression models.<br/> RESULTS: No significant difference existed in survival time to first diarrheal illness (log rank P = .55). The incidences of diarrheal episodes were 3.43 (95% confidence interval [CI], 3.28-3.59) and 3.59 per child-year (95% CI, 3.44-3.76) in the placebo and intervention arms, respectively. Vitamin D3 supplementation was found to have no effect on the risk for recurrent diarrheal disease in either intention-to-treat (HR, 1.05; 95% CI, 0.98-1.17; P = .15) or per protocol (HR, 1.05; 95% CI, 0.98-1.12; P = .14) analyses. The lack of preventive benefit remained when the randomized population was stratified by age groups, nutritional status, and seasons.<br/> CONCLUSIONS: Quarterly supplementation with vitamin D3 conferred no reduction on time to first illness or on the risk for recurrent diarrheal disease in this study. Similar supplementation to comparable populations is not recommended. Additional research in alternative settings may be helpful in elucidating the role of vitamin D3 supplementation for prevention of diarrheal diseases.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 24019420
Web of Science ID: 325095400004
URI: http://researchonline.lshtm.ac.uk/id/eprint/1194230

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