EFFECT OF VITAMIN A ON SEVERITY OF ACUTE

DIARRHEA IN CHILDRENBy: Marlisye Marpaung, Suprianto, Atan Baas SinuhajiDepartement of Child Health, University of North Sumatera Medical School, Medan

Presented by: Sisilia Elfani Pebiantia, S.Ked

Background

Vitamin A deficiency may increase the risk or be a cause of diarrhea. Many studies have been conducted on the efficacy of vitamin A in the management of acute

diarrhea, but the outcomes remain inconclusive.

Objective

To determine the effectiveness of vit-A in reducing the severity

of acute diarrhea in children

Methods

Methods• single-blind-randomized controlled trial

Subject

• children age 6 months to 5 years, who had diarrheas at Puskesmas Hina Kiri

Time• August 2009 to Januari 2010

Subject• Group 1• Receive a single dose of vit A 100.000 IU for subject age 6-11month old or with body weight ≤ 10 kg, 200.000 IU for ≥12 month old or with body weight >10 kg.

• Group 2• Receive a single dose of placebo.

Severity

• based on changes in diarrheal frequency, stool consistency, volume and duration of diarrhea after treatment.

Statistical analyses

• independent T-test and Chi square tests

Included• Children aged 6 month to

5 years with acute diarrhea.

Excluded• Children with severe dehydration,

cholera, critically ill conditions (severe malnutrition, encephalitis, meningitis, sepsis, bronchopneumonia, TB)

• Children wo consumed vit A 4 months to avoid hyperavitaminosis conditions,

• Suffered from measles in the 6 weeks prior the study, conditions that may lead to vitamin A deficiency and have a positive response to vitamin A supplementation.

Diarrhea• In Indonesia, diarrhea remains a major cause of death in

infant and children.• In the GIT, VAD is both cause and consequence of

diarrheal disease.• In 20th century, vitamin A was commonly known as the

anti-infective vitamin, when its deficiency was shown to be associated with various infections. However, the mechanism by which vitamin A protects the body against infection is unclear.

HASIL PENELITIAN

• A deficiency adversely affects the epithelial lining, leading to decreased mucous secretion and weakened local barriers to infection. Vitamin A deficiency may also lead to goblet cell depletion, abnormal villous architecture and villous atrophy, as well as adversely affecting humoral and cellular Immune functions

• Studies conducted in many countries have shown a benefit of vitamin A in treating diarrhea

CONCLUSIONS

Vitamin A supplementationis effective in reducing the severity of acute diarrhea in children under five years of age.