Vitamin A Supplementation at Birth and Atopy in Childhood
Recruitment status was: Active, not recruiting
INTRODUCTION Eight trials studying the effect of providing neonatal vitamin A supplementation (NVAS) have been reported, and another four are underway to test whether NVAS should become WHO policy. Three of the four African trials were conducted by the Bandim Health Project (BHP) in Guinea-Bissau. One of them was a two-by-two factorial trial among low-birth-weight children. From 2004-2008, the children were randomly allocated to 25,000 IU vitamin A or placebo at birth, and furthermore to BCG vaccination at birth or later as is local policy. In 2011, the investigators conducted a follow-up study. A remarkably strong harmful effect of NVAS on atopy and wheezing was found (manuscript under review).
Seen in the context that NVAS may soon become a WHO policy it is obviously worrying if NVAS is associated with a higher risk of atopy and wheezing. The investigators therefore aim to conduct a similar follow-up study of participants in the first NVAS trial conducted in Guinea-Bissau from 2002-2004, among normal-birth-weight infants, to test whether NVAS is associated with an increased risk of atopy and wheezing and other allergic symptoms as well as growth.
From 2002-2004 BHP conducted a randomised trial of NVAS. The investigators recruited newborns when they came for BCG vaccination. Provided parental consent, they received an oral supplement of 50,000 IU vitamin A or placebo.
This study will be a follow-up study of the cohort of children randomised to NVAS (intervention) or placebo (current policy) together with BCG vaccine at birth.
The investigators will also investigate the effect of receiving an additional dose of measles vaccine and the timing of DTP vaccine on the development of atopy.
Assessment of outcomes:
The investigators will visit all children at the last known address. Height, weight and mid upper arm circumference will be measured. BCG scar will be examined and vaccination card details recorded by the field assistant. Children will be excluded from skin prick testing (SPT) if they have a history suggestive of anaphylaxis or are currently using anti-histamine medication. SPT will be performed using aero-allergens, food allergens and positive histamine and negative saline control. The mother or guardian will be interviewed by a local assistant. Symptoms of eczema and asthma as well as food allergy will be assessed.
Effect of randomisation group and other factors on outcomes will be analysed in multivariable regression models. All analyses will be adjusted for skin prick tester. All analyses will be conducted stratified by sex.
|Atopy Asthma Eczema Food Allergy|
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||The Effect of Vitamin A Supplementation at Birth on the Development of Atopy in Childhood: Long-term Follow-up of a Randomised Placebo-controlled Trial|
- Atopic sensitisation [ Time Frame: Single observation on day of recruitment ]Skin prick test positivity. A wheal >=3mm will be considered positive.
- Symptoms of asthma [ Time Frame: Single observation on day of recruitment ]Questionnaire based on ISAAC survey for 6-7 year olds
- Symptoms of eczema [ Time Frame: Single observation on day of recruitment ]Questionnaire based on ISAAC survey for 6-7 year olds
- Symptoms of food allergy [ Time Frame: Single observation of day of recruitment ]Questionnaire based on Health Nuts survey
- Weight [ Time Frame: Single observation on day of recruitment ]
- Height [ Time Frame: Single observation on day of recruitment ]
- Mid-upper arm circumference [ Time Frame: Single observation on day of recruitment ]
- Hospitalisations [ Time Frame: Single observation on day of recruitment ]
- Infectious diseases [ Time Frame: Single observation on day of recruitment ]History of chickenpox or measles
|Study Start Date:||January 2013|
|Estimated Study Completion Date:||February 2014|
|Primary Completion Date:||November 2013 (Final data collection date for primary outcome measure)|
Please refer to this study by its ClinicalTrials.gov identifier: NCT01779180
|Bandim Health Project|
|Bissau, Bissau Codex, Guinea-Bissau, 1004|
|Principal Investigator:||Christine Benn, DMSc||Statens Serum Institut|