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A 210-µmol Dose of Vitamin A Provides More Prolonged Impact on Vitamin A Status than 105 µmol among Preschool Children^{1, 2,}

Jean H. Humphrey³, Gantira Natadisastra^*, Muhilal, David S. Friedman, James M. Tielsch, Keith P. West, Jr. and Alfred Sommer

Dana Center for Preventive Ophthalmology, Johns Hopkins Schools of Medicine and Hygiene and Public Health, Baltimore, MD 21287 ^* Cicendo Eye. Hospital, Bandung, Indonesia Nutrition Research and Development Centre, Bogor, Indonesia

A randomized controlled clinical trial was conducted to determine the relative protection afforded by two large doses of vitamin A against subclinical vitamin A deficiency among 345 preschool children. At baseline, children either had or were at high risk of developing non-corneal xerophthalmia. Vitamin A status was assessed by the relative dose response (RDR) test, serum retinol concentration, and ocular examination before and 3 and 6 mo following one oral dose of 105 µmol or 210 µmol of vitamin A. At 3 and 6 mo, mean serum retinol concentration was significantly higher in the 210-µmol group than in the 105-µmol group. The proportion of children with a positive RDR did not differ between groups at 3 mo, but by 6 mo there were three times more children positive in the 105-µmol group. Most of the observed difference was confined to children with xerophthalmia at baseline. The relative benefit of the 210-µmol dose was related to baseline vitamin A status. The current World Health Organization recommended prophylactic dose of 210 µmol seems appropriate.

KEY WORDS: • periodic vitamin A dosing • xerophthalmia • vitamin A • children • Indonesia

¹ Supported by The Thrasher Research Fund and cooperative agreement no. DAN-0045-A-5094 between the Dana Center for Preventive Ophthalmology, The Johns Hopkins University and the Bureau of Research and Development, Office of Nutrition, U.S. Agency for International Development, Washington, DC, with assistance from Task Force Sight and Life, Hoffmann LaRoche, Basel, Switzerland.

² The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact.

³ To whom correspondence should be addressed.

Manuscript received 13 August 1993. Revision accepted 18 February 1994.

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