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CSU 42/2010: TWO ON MEASLES
A review of the evidence, by authors from Duke and Johns Hopkins, reviewing the evidence on measles vaccination and the evidence on using two doses of vitamin A for treatment of measles. Full text, with graphics, is available, open source, at http://ije.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=20348126
The WHO/UNICEF guidelines call for oral administration of vitamin A to all measles cases on Day 1 and Day 2 of treatment, for reduction of case fatality and of blindness. The authors find an impact when two doses are given.
From their conclusions:
'Vitamin A deficiency is a recognized risk factor for severe measles and since 1987 the WHO and UNICEF have recommended vitamin A treatment of children with measles.70 We performed a meta-analysis of six vitamin A treatment RCTs with measles-specific mortality data and found no significant reduction in measles morality [RR 0.63; 95% CI (0.37–1.08)]. However, when stratifying the analysis by vitamin A treatment dose, at least two doses of 200 000 IU for children 1 year of age and 100 000 IU for infants was found to reduce measles mortality by 62% [RR 0.38; 95% CI (0.18–0.81)]. These results support the current recommendation that two doses of vitamin A be offered to children with measles (emphasis added)"
Good reading.
BD