Vitamin A deficiency and intestinal parasitism coexist in developing countries. This study evaluated whether a national program of vitamin A supplementation (200,000IU retinyl palmitate every 6 months), if combined with deworming (400mg albendazole), slows reinfection with Ascaris . A baseline survey of 595 indigenous preschool children in the Bocas del Toro region of Panama showed high rates of stunting (61%) and nematode infection (Ascaris 79.5%, Trichuris 19%). All children were dewormed and 328 were included in the 5 month follow-up study. Of these, 106 children received vitamin A supplementation through the Ministry of Health (Vit A S+) and 222 children received no supplementation (Vit A S-). At 3 months post deworming, both the prevalence (P= 0.0004) and intensity (P= 0.0124) of Ascaris infection were higher in Vit A S- children than in Vit A S+ children, indicating that reinfection occurred more slowly in supplemented children. When the two supplement groups were further sub-divided by stature, Vit A S+ resulted in lower reinfection rates (P=0.0002) only in normal height children, and not in stunted children. Despite the tendency of public health policy to target malnourished children our study provides evidence of increased benefit of vitamin A supplementation in normal height children living in areas with chronic parasitosis.

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