Vitamin E and Vitamin C Supplementation does not Improve the Clinical Course of Measles with Pneumonia in Children: a Controlled Trial

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aSociety for Applied Studies, Kolkata, bInfectious Diseases Hospital, and cKothari Medical Research Centre, Kolkata, India, dICDDR-B Center for Health and Population Research, Dhaka, Bangladesh and eUniversity of Alabama at Birmingham, USA

Pneumonia is an important cause of measles-associated deaths [1]. We evaluated two dietary anti-oxidants, vitamins E and C as adjunct therapy of pneumonia in children with severe measles in a randomized double masked placebo controlled trial.

Children aged 1–10 years admitted with illness compatible with measles (generalized maculo-papular rash with fever and at least one of cough, coryza or conjunctivitis) and associated pneumonia at the Infectious Diseases Hospital, Kolkata were randomized to (a) vitamin E and vitamin C (each 200 mg twice daily for 6 days) and (b) placebo supplemented groups and the impact on the clinical course of illness was evaluated. Outcome measures were, time to resolution of fever (skin temp 98°F), tachyponea (rate <40/min for 1–5 yrs and <30/min for 6–10 yrs), difficulty to eat and/or drink, and a very ill status (as judged by the clinician not aware of treatment allocation) during the 6 days of treatment. The Ethical Review Committee of the Institution approved the study. Parents gave informed consent. All patients received a single oral dose of vitamin A 200 000 IU at admission. A child was considered clinically ‘cured’ or ‘much improved’ based on, (a) alertness and general well being, (b) resolution of tachypnoea and or respiratory distress, (c) how well the child eats/drinks, and (d) resolution of fever. We measured serum α-tocopherol in a sub-sample using HPLC and TBARS (thiobarbituric acid reacting substances) by methods described earlier [2] at admission and discharge. We used Cox proportional hazards regression model to compare the duration of the illness indicators.