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Efficacy of a single oral dose of 200,000 iu of oil-soluble vitamin A in measles-associated morbidity.
AMERICAN JOURNAL OF EPIDEMIOLOGY. 1996 Mar 1; 143(5):413-22.In 1991, in Ndola, Zambia, staff at urban health centers randomly allocated children with acute measles who did not require hospitalization to receive either a single oral dose of 200,000 IU of oil-soluble vitamin A (90 children) or a placebo (110 children). (A single oral administration of vitamin A at this dose is recommended by the World Health Organization [WHO]). This double-blind placebo-controlled clinical study aimed to determine whether or not a single oral dose of vitamin A would minimize measles-associated morbidity in children who do not require hospitalization. The cross-sectional analysis revealed that at week 4 the vitamin A group was more likely than the placebo group to have no symptoms of acute respiratory infection (ARI) (93% vs. 78%) and less likely to have pneumonia (0 vs. 12%) (p = 0.005). It did not find any significant association prior to week 4, however. None of the three longitudinal analyses found vitamin A to have a significant benefit on morbidity. These analyses considered the effect of treatment on the movement of individual patients between ARI health states. The odds ratio for pneumonia in children with measles-associated cough and for measles-associated cough or pneumonia in asymptomatic measles patients suggested that vitamin A minimized morbidity (0.73 and 0.52, respectively). Yet vitamin A failed to improve pneumonia (odds ratio = 1.23, in favor of placebo). These findings suggest that a single oral dose of 200,000 IU of oil-soluble vitamin A is not as effective at preventing measles complications as that indicated earlier for two 200,000 IU doses of water-miscible vitamin A. Thus, the WHO recommendations need to be reconsidered.
Contraception. 1982 Mar; 25(3):231-41.A randomized, controlled, clinical trial comparing 6 combined oral contraceptives (OCs) with 50 mcg or less of ethinyl estradiol was undertaken in 10 WHO Collaborating Centers for Clinical Research in Human Reproduction. A total of 2430 women entered the trial and were observed for 28,077 woman-cycles. All low-dose combined OCs demonstrated equivalent efficacy with 1-year pregnancy rates of 1-6%. However, discontinuation rates for medical reasons differed significantly between the treatment groups with the preparation containing 20 mcg ethinyl estradiol and that containing 400 mcg norethisterone acetate being associated with higher discontinuation rates due to bleeding disturbances. Even among the preparations which did not differ in discontinuation rates, the reasons for discontinuation did differ. Women receiving norethisterone preparations tended to discontinue because of bleeding disturbances while those receiving the levonorgestrel-containing preparations tended to discontinue because of complaints of nausea and vomiting. (author's)