Objective: To investigate the association between vitamin A status and conjunctival epithelial function in young children in rural northern Ghana and to consider whether impaired epithelial function was associated with increased measures of systemic infection in these children.
Design: Children were selected from the Ghana Vitamin A Supplementation Trials' Child Health Study, a randomized, double-blind, placebo-controlled trial of the effect of vitamin A supplementation on morbidity. Treatment group and serum retinol concentrations were used as measures of vitamin A status, conjunctival impression cytology and tear IgA concentrations as measures of conjunctival epithelial integrity, and serum immunoglobulin and alpha 1-acid glycoprotein concentrations as indicators of chronic or acute systemic infection.
Subjects: Children 13-64 months old.
Intervention: 60 mg retinol as retinyl palmitate every 4 months for 1 year.
Results: Vitamin A status was not significantly associated with epithelial integrity nor with measures of systemic infection. Impaired conjunctival epithelial integrity was also not associated with increased systemic infection.
Conclusions: There was no evidence for a major role of improved epithelial integrity and function on the biochemical indices of chronic or acute systemic infection after vitamin A supplementation. These data support the observations in the main study that vitamin A supplementation did not improve conjunctival impression cytology nor decrease the prevalence of most morbidity symptoms.
PIP: Vitamin A deficiency is associated with an increased risk of mortality among young children. The authors report findings from their study of whether vitamin A deficiency was associated with epithelial defects which might result in impaired mucosal protection and increased systemic infection in children. Samples and data were used from the Ghana Vitamin A Supplementation Trials' Child Health Study, a randomized, double-blind, placebo-controlled study of the effect of periodic large doses of vitamin A on the morbidity of young children. 80 children aged 13-64 months in rural northern Ghana received 60 mg retinol as retinyl palmitate every four months for one year. The study found vitamin A status to be significantly associated with neither epithelial integrity nor measures of systemic infection. Impaired conjunctival epithelial integrity was also not associated with increased systemic infection. These data support observations in the broader study that vitamin A supplementation does not improve conjunctival impression cytology or decrease the prevalence of most morbidity symptoms.