Evaluation of the uptake and impact of neonatal vitamin A supplementation delivered through the Lady Health Worker programme on neonatal and infant morbidity and mortality in rural Pakistan: an effectiveness trial

Soofi, Sajid Bashir; Ariff, Shabina; Sadiq, Kamran; Habib, Atif; Bhatti, Zaid; Ahmad, Imran; Hussain, Masawar; Ali, Naureen Akber; Bhutta, Zulfiqar A

doi:10.1136/archdischild-2016-310542

Cited by 14 publications

(22 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We pooled the data for all-cause mortality from community-based studies only. Data were available from five studies for all-cause mortality at 1 month [22,26,30,32,33]. The pooled results did not show any significant difference for vitamin A supplemented group compared to control (RR 0.99, 95% CI 0.90, 1.08).…”

Section: All-cause Mortalitymentioning

confidence: 97%

“…Figure 1 shows the results of literature search. We included sixteen studies for vitamin A supplementation [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37], thirty three studies in probiotics supplementation and no study was found for dextrose gel supplementation.…”

Section: Literature Searchmentioning

confidence: 99%

“…Overall, all the included studies were randomized controlled trials. Thirteen studies were individually randomized [23][24][25][26][27][28][29][31][32][33][34][35]37] and 3 studies were cluster-randomized [22,30,36]. Three trials had multiple arms of interventions [24,25,31].…”

Section: Vitamin a Supplementation During The Neonatal Periodmentioning

confidence: 99%

“…Three trials had multiple arms of interventions [24,25,31]. The included studies were conducted in 10 different countries with 4 studies in India [29,33,34,37], 3 studies conducted in Guiana Bissau [23][24][25], 2 studies in Bangladesh [28,30] and one each in Indonesia [27], Nepal [36], Ghana [26], Tanzania [32], Zimbabwe [31], China [35] and Pakistan [22]. Thirteen studies were conducted in the community settings while three Nutrients 2020, 12, 791 6 of 21 studies were conducted in the hospital settings and included very low birth weight babies [29,35,37].…”

Section: Vitamin a Supplementation During The Neonatal Periodmentioning

confidence: 99%

“…Use of fixed effect model did not change the summary estimate for neonatal mortality (RR 0.99, 95% CI 0.90, 1.08). Twelve studies from community settings reported the data for effect of neonatal vitamin A supplementation on all-cause mortality at 6 months [22][23][24][26][27][28][30][31][32][33][34]36]. The combined results showed no significant difference between the intervention and control group [RR 0.98; 95 CI 0.89, 1.07) ( Figure 2).…”

Section: All-cause Mortalitymentioning

confidence: 99%

See 4 more Smart Citations

Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries

et al. 2020

View full text Add to dashboard Cite

Background: Suboptimal nutritional status of a newborn is a risk factor for short-and long-term morbidity and mortality. The objectives of this review were to assess the efficacy and effectiveness of neonatal synthetic vitamin A supplementation, dextrose gel and probiotic supplementation for prevention of morbidity and mortality during infancy in low and middle-income countries. Methods: We included randomized trials. Primary outcome was all-cause mortality. We conducted electronic searches on multiple databases. Data were meta-analyzed to obtain relative risk (RR) and 95% confidence interval (CI). Studies for vitamin A and Probiotics were analyzed separately. No studies were found for dextrose gel supplementation during neonatal period. The overall rating of evidence was determined by Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Sixteen studies assessed the effect of vitamin A supplementation during the neonatal period. Based on pooled data from community-based studies only, there was no significant effect of vitamin A on all-cause mortality at age 1 month (RR 0.99, 95% CI 0.90, 1.08), 6 months (RR 0.98; 95% CI 0.89-1.08) and 12 months (RR 1.04, 95% CI 0.94, 1.14) but increased risk of bulging fontanelle (RR 1.53, 95% CI 1.12, 2.09). The overall quality of evidence was high for the above outcomes. Thirty-three studies assessed the effect of probiotic supplementation during the neonatal period and were mostly conducted in the hospital setting. Probiotics reduced the risk of all-cause mortality (RR 0.80, 95% CI 0.66, 0.96), necrotizing enterocolitis (RR 0.46, 95% CI 0.35, 0.59) and neonatal sepsis (RR 0.78, 95% CI 0.70, 0.86). The grade ratings for the above three outcomes were high. Conclusions: Vitamin A supplementation during the neonatal period does not reduce all-cause neonatal or infant mortality in low and middle-income countries in the community setting. Probiotic supplementation during the neonatal period seems to reduce all-cause mortality, NEC, and sepsis in babies born low birth weight and/or preterm in the hospital setting.

show abstract

Section: All-cause Mortalitymentioning

confidence: 97%

Section: Literature Searchmentioning

confidence: 99%

Section: Vitamin a Supplementation During The Neonatal Periodmentioning

confidence: 99%

Section: Vitamin a Supplementation During The Neonatal Periodmentioning

confidence: 99%

Section: All-cause Mortalitymentioning

confidence: 99%

See 3 more Smart Citations

Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries

et al. 2020

View full text Add to dashboard Cite

show abstract

Integrated community case management of childhood illness in low- and middle-income countries

Oliphant

Manda

Daniels

et al. 2021

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

Effects of neonatal nutrition interventions on neonatal mortality and child health and development outcomes: A systematic review

Imdad

Rehman

Davis

et al. 2021

Campbell Systematic Reviews

View full text Add to dashboard Cite

Background The last two decades have seen a significant decrease in mortality for children <5 years of age in low and middle‐income countries (LMICs); however, neonatal (age, 0–28 days) mortality has not decreased at the same rate. We assessed three neonatal nutritional interventions that have the potential of reducing morbidity and mortality during infancy in LMICs. Objectives To determine the efficacy and effectiveness of synthetic vitamin A, dextrose oral gel, and probiotic supplementation during the neonatal period. Search Methods We conducted electronic searches for relevant studies on the following databases: PubMed, CINAHL, LILACS, SCOPUS, and CENTRAL, Cochrane Central Register for Controlled Trials, up to November 27, 2019. Selection Criteria We aimed to include randomized and quasi‐experimental studies. The target population was neonates in LMICs. The interventions included synthetic vitamin A supplementation, oral dextrose gel supplementation, and probiotic supplementation during the neonatal period. We included studies from the community and hospital settings irrespective of the gestational age or birth weight of the neonate. Data Collection and Analysis Two authors screened the titles and extracted the data from selected studies. The risk of bias (ROB) in the included studies was assessed according to the Cochrane Handbook of Systematic Reviews. The primary outcome was all‐cause mortality. The secondary outcomes were neonatal sepsis, necrotizing enterocolitis (NEC), prevention and treatment of neonatal hypoglycaemia, adverse events, and neurodevelopmental outcomes. Data were meta‐analyzed by random effect models to obtain relative risk (RR) and 95% confidence interval (CI) for dichotomous outcomes and mean difference with 95% CI for continuous outcomes. The overall rating of evidence was determined by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Main Results Sixteen randomized studies (total participants 169,366) assessed the effect of vitamin A supplementation during the neonatal period. All studies were conducted in low‐ and middle‐income (LMIC) countries. Thirteen studies were conducted in the community setting and three studies were conducted in the hospital setting, specifically in neonatal intensive care units. Studies were conducted in 10 different countries including India (four studies), Guinea‐Bissau (three studies), Bangladesh (two studies), and one study each in China, Ghana, Indonesia, Nepal, Pakistan, Tanzania, and Zimbabwe. The overall ROB was low in most of the included studies for neonatal vitamin A supplementation. The pooled results from the community based randomized studies showed that there was no significant difference in all‐cause mortality in the vitamin A (intervention) group compared to controls at 1 month (RR, 0.99; 95% CI, 0.90–1.08; six studies with 126,548 participants, statistical heterogeneity I2 0%, funnel plot symmetrical, grade rating high), 6 months (RR, 0.98; 95% CI, 0.89–1.07; 12 studies with 154,940 participan...

show abstract

Evaluation of the uptake and impact of neonatal vitamin A supplementation delivered through the Lady Health Worker programme on neonatal and infant morbidity and mortality in rural Pakistan: an effectiveness trial

Cited by 14 publications

References 28 publications

Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries

Effect of Synthetic Vitamin A and Probiotics Supplementation for Prevention of Morbidity and Mortality during the Neonatal Period. A Systematic Review and Meta-Analysis of Studies from Low- and Middle-Income Countries

Integrated community case management of childhood illness in low- and middle-income countries

Effects of neonatal nutrition interventions on neonatal mortality and child health and development outcomes: A systematic review

Contact Info

Product

Resources

About