SynthesisNutrition journal2013
Review of the safety and efficacy of vitamin A supplementation in the treatment of children with severe acute malnutrition.
Synthesis in Nutrition journal, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03400930 (OptiDiag), which is not on this map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
OptiDiag: Biomedical Investigations for Optimized Diagnosis and Monitoring of Severe Acute Malnutrition (SAM): Elucidating the Heterogeneous Diagnosis of SAM by Current Anthropometric Criteria and Moving Beyond
Who cites it
11 citing papers in PubMed, 23 citations in OpenAlex.
- Time to stabilization among under-five children with severe acute malnutrition in Ethiopia: a retrospective cohort study.BMC public health · 2025Article
- Micronutrient supplementation practices in relation to the World Health Organisation 2013 guidelines on management of severe acute malnutrition.Maternal & child nutrition · 2024Article
- Prevalence and multi-level factors associated with acute malnutrition among children aged 6-59 months from war affected communities of Tigray, Northern Ethiopia, 2021: a cross-sectional study.Conflict and health · 2023Article
- Article
- Treatment outcome and associated factors for severely malnourished children (1-5 years) admitted to Lacor Hospital and Gulu Regional Referral Hospital in Uganda.Journal of nutritional science · 2021Article
- Effectiveness of interventions to manage acute malnutrition in children under 5 years of age in low- and middle-income countries: A systematic review.Campbell systematic reviews · 2020Review
- Rubella Virus Infection, the Congenital Rubella Syndrome, and the Link to Autism.International journal of environmental research and public health · 2019Review
- Factors affecting low coverage of the vitamin A supplementation program among young children admitted in an urban diarrheal treatment facility in Bangladesh.Global health action · 2019Article
- PROTOCOL: Effectiveness of interventions to manage acute malnutrition in children under five years of age in low- and middle-income countries: a systematic review.Campbell systematic reviews · 2018Article
- Impact of Childhood Malnutrition on Host Defense and Infection.Clinical microbiology reviews · 2017Review
- Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE).The Journal of nutrition · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWorld Health Organization (WHO) guidelines recommend for children with severe acute malnutrition (SAM), high-dose vitamin A (VA) supplements be given on day 1 of admission, and on days 2 and 14 in the case of clinical signs of vitamin A deficiency (VAD). Daily low-dose VA follows, delivered in a premix added to F-75 and F-100. This study aimed to systematically review the evidence for safety and effectiveness of high-dose VA supplementation (VAS) in treatment of children with SAM.
methodsA comprehensive literature review was undertaken for all relevant randomized controlled trials (RCT) and observational studies from 1950 to 2012. Studies identified for full review were evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology using a set of pre-defined criteria: indirectness; inconsistency; imprecision; and study limitations. A quality rating of high, moderate, or low was then assigned to each study, and only those attaining moderate to high were considered in making recommendations.
resultsOf the 2072 abstracts screened, 38 met criteria for full review, and 20 were rated moderate to high quality. Only one study replicated the WHO VA protocol in children with SAM. Indirectness was a critical limitation, as studies were not exclusive to children with SAM. There was inconsistency across trials for definitions of malnutrition, morbidities, and ages studied; and imprecision arising from sub-group analyses and small sample sizes. Evidence showed improved outcomes associated with low-dose compared to high-dose VAS, except in cases presenting with signs of VAD, measles, and severe diarrhea or shigellosis. Adverse outcomes related to respiratory infection, diarrhea, and growth were associated with high-dose VAS in children who were predominantly adequately nourished. No adverse effects of the high dose were found in children with SAM in the trial that replicated the WHO VA guideline.
conclusionThis is the first systematic review of the safety and efficacy of high-dose VAS in treatment of SAM. We recommend a low-dose VAS regimen for children with SAM, except in cases presenting with measles, severe diarrhea (shigellosis), and any indication of VAD. Further research is needed in exclusively malnourished children and to explore alternate delivery strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.