Vitamin-A
It was with great concern that I read the reports of the death of some children, and of others getting ill, following the recent administration of vitamin A capsules and de-worming tablets.
I will not comment on the de-worming tablets because I have no information on the generic nomenclature of the drug that was used for the purpose.
My search of the literature and the websites (including Pub Med) did not reveal too many adverse reactions to vitamin A. Notable among those reported are rashes, blue or black pigmentation of the skin, headache, diarrhoea, vomiting, swelling of the mouth, face, lips and tongue, dizziness/ drowsiness, double vision, breathing difficulty and tightness in the chest.
I also searched the Health Canada Adverse Reaction Database and was able to come up with only 3 cases (of children between the ages of 2-14 years) since 1965 in which adverse reaction to vitamin A was reported. These included fever, headache, nausea etc.
Adverse reactions may be observed with any medication or supplementation, and it is not unusual that some may be observed following supplementation with vitamin A. However, the two questions that I would like to ask at this point are: (1) Why are there so many reported cases of adverse reactions to vitamin A? (2) What could account for the fact that deaths will occur as the supposed direct consequence of the oral administration of vitamin A?
I am very confident that the highly knowledgeable medical community of Bangladesh will be able to provide the proper answers to these questions. However, in this regard, I would like to draw the attention of all concerned to the following:
(1) Ensuring accurate notification and documentation of the cases, and determination of the cause-effect relationship.
(2) Existing nutritional and immune system status of the target population.
(3) Target population selection criteria.
(4) Validity of the medication/supplementation.
(5) Drug quality compromise resulting from transportation/storage.
I am hopeful that the committee formed to probe the matter will be able to provide an acceptable explanation and suggest measures to avoid a repetition of the same in the future.
Dr. C. Zaman, Ottawa, Ontario, Canada
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I was frightened to learn the news that a number of innocent children in Madaripur fell ill after taking vitamin-A capsule.
The government should go for a thorough probe into the matter.
Md. Zahidul Islam Zibon, Dept. of English, International Islamic University Chittagong
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