Does vitamin A supplementation protect schoolchildren from acquiring soil-transmitted helminthiasis? A randomized controlled trial

Hesham M Al-Mekhlafi, Tengku Shahrul Anuar, Ebtesam M Al-Zabedi, Mohamed T Al-Maktari, Mohammed A K Mahdy, Abdulhamid Ahmed, Atiya A Sallam, Wan Ariffin Abdullah, Norhayati Moktar, Johari Surin, Hesham M Al-Mekhlafi, Tengku Shahrul Anuar, Ebtesam M Al-Zabedi, Mohamed T Al-Maktari, Mohammed A K Mahdy, Abdulhamid Ahmed, Atiya A Sallam, Wan Ariffin Abdullah, Norhayati Moktar, Johari Surin

Abstract

Background: Despite the intensive global efforts to control intestinal parasitic infections, the prevalence of soil-transmitted helminth (STH) infections is still very high in many developing countries particularly among children in rural areas.

Methods: A randomized, double-blind, placebo-controlled trial was conducted on 250 Aboriginal schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on STH reinfection. The effect of the supplement was assessed at 3 and 6 months after receiving interventions; after a complete 3-day deworming course of 400 mg/daily of albendazole tablets.

Results: Almost all children (98.6%) were infected with at least one STH species. The overall prevalence of ascariasis, trichuriasis and hookworm infection was 67.8%, 95.5% and 13.4%, respectively. Reinfection rates of Ascaris, Trichuris and hookworm were high; at 6 months, assessment reached 80% of the prevalence reported before treatment. There were no significant differences in the reinfection rates and intensities of STH between vitamin A supplemented-children and those who received placebo at 3 and 6 months (p > 0.05).

Conclusions: Vitamin A supplementation showed no protective effect against STH reinfection and this could be due to the high endemicity of STH in this community. Long-term interventions to reduce poverty will help significantly in reducing this continuing problem and there is no doubt that reducing intestinal parasitic infection would have a positive impact on the health, nutrition and education of these children.

Trial registration: This trial was registered at clinicaltrials.gov as NCT00936091.

Figures

Figure 1
Figure 1
A geographic map showing the study area (location of school and villages in Lipis district).
Figure 2
Figure 2
Flow chart of data collection and follow up.

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