The national coverage rate (percentage of target age children who received vitamin A capsules during the past six months, according to information provided by the mothers) of vitamin A in rural areas was 45% in 1982-83[52]. The rate gradually decreased to 37% in 1987-88 and 35% in 1989 respectively [53], [54]. However, the Nutritional Surveillance Project reported in December 1995, that the coverage of vitamin A capsule distribution increased substantially- 83.6% in rural and 73.7% in the urban areas [54]. It is noteworthy that night blindness is considered as the marker of vitamin A deficiency, and when that exceeds 1%, is considered as a significant public health problem [55]. In Bangladesh, the proportion of children aged 18-59 months having night blindness in rural areas and urban slums were 0.23% and 0.12% respectively [52]. These figures are well below the cut-off for public health significance of vitamin A deficiency. Anecdotal observations of doctors working at the ICDDR, B Hospital, Dhaka, indicate a significant decrease in the number of children with clinical vitamin A deficiency seeking treatment in the hospital. Further more, according to a report of the surveillance system of Dhaka Hospital of ICDDR, B 84 children presented with conjunctival xerosis and only three had keratomalacia/corneal ulcer out of the total of 11,605 under-5 children who attended the hospital during the period 1996-2004. Children to be enrolled in our proposed study will receive 5000 IU of vitamin A. That amounts to be an additional 1000 IU during the acute phase and 800 IU during the nutritional rehabilitation phase of severe malnutrition from various diets provided to them during their hospital stay. We thus estimate that the total amount of vitamin A received from these sources, even after adjusting for urinary excretion and the retinol level, will not fall below the basal and normal requirements. We feel that once we are able to maintain the daily optimal level of vitamin A stores in the body the sudden development of keratomalacia can be averted. However, we will remain vigilant, through performing careful clinical examination (of eye and skin), to exclude children with any form of clinical vitamin A deficiency from enrollment. Children with clinical vitamin A deficiency disease (conjunctival xerosis, Bitot's spots, keratomalacia, or dermatosis suggestive of vitamin A deficiency) will not be eligible for enrollment and will be provided with the currently recommended treatment with vitamin A supplementation as is routinely followed in this hospital. It may also be noted that a couple of studies did not observe development of an overt sign of vitamin A deficiency in children not receiving vitamin A (placebo group) [15, 41]. Additionally, serum retinol concentrations were not significantly changed after 7 days of hospitalization both among children receiving the high dose and children receiving the low dose or placebo [15].