WikiJournal of Medicine/Vitamin D as an adjunct for acute community-acquired pneumonia among infants and children: systematic review and meta-analysis/XML

From Wikiversity
Jump to navigation Jump to search
<?xml version="1.0" encoding="UTF-8"?>
<doi_batch version="4.4.0" xmlns="" xmlns:xsi="" xsi:schemaLocation="">
   <email_address><span class="nowrap">Contact[[File:At sign.svg|15px|@|link=]]</span></email_address>
    <full_title>WikiJournal of Medicine/Vitamin D as an adjunct for acute community-acquired pneumonia among infants and children: systematic review and meta-analysis</full_title>
    <issn media_type='electronic'></issn>
    <publication_date media_type='online'>     
   <journal_article publication_type='full_text'>   
     <title>Vitamin D as an adjunct for acute community-acquired pneumonia among infants and children: systematic review and meta-analysis</title>
    <person_name sequence='first' contributor_role='author'>
    </person_name><person_name sequence='additional' contributor_role='author'>
     <surname>Lassi</surname><given_name>Zohra</given_name><ORCID></ORCID><affiliation>Robinson Research Institute, University of Adelaide, Australia</affiliation>
    <publication_date media_type='online'>     
     <resource> of Medicine/Vitamin D as an adjunct for acute community-acquired pneumonia among infants and children: systematic review and meta-analysis</resource>
    <license license-type="open-access">
     <license-p>[[File:Open_Access_logo_PLoS_white.svg|11px|link=Wikipedia:Open Access]] [[|16px|link=Wikipedia:Creative Commons]]
This is an open access article distributed under the&nbsp;[ Creative Commons Attribution License], which permits unrestricted use, distribution, and reproduction, provided the original author and source are credited.</license-p>
Plain language summary{| class="cquote" style="margin:auto; border-collapse: collapse; border: none; background-color: transparent; width: auto; "| width="20" valign="top" style="border:none; color:#B2B7F2;font-size:35px;font-family: 'Times New Roman', serif; font-weight: bold; text-align: left; padding: 10px 10px;" | “| valign="top" style="border: none; padding: 4px 10px;" | Pneumonia is the most important cause of death in children under five years old. Most deaths  occurs in children in low- and middle-income countries who have poor nutrition and  lower immunity. Standard medical therapy consists of antibiotics and supportive care.Vitamin D is cheap and known to improve the immune system  response against respiratory diseases such as tuberculosis. Previous studies have examined whether vitamin D supplements are useful to prevent pneumonia, but less attention has been paid to the use of vitamin D to aid in the treatment of pneumonia.This study searched the literature and found three clinical trials of vitamin D as an additional treatment for pneumonia in children. These trials were from India or Afghanistan and included 997 infants and children in total. Taken together, these trials showed no effect of vitamin D cure rates, mortality, time to clinical recovery or duration of hospital stay for pneumonia in children. The quality of evidence is however low. The authors conclude that current evidence is limited but does not support the use of vitamin D supplements during treatment of pneumonia in children. Further trials are needed on this topic.| width="20" valign="bottom" style="border: none; color: #B2B7F2; font-size: 35px; font-family: 'Times New Roman', serif; font-weight: bold; text-align: right; padding: 10px 10px;" | ”|-|}Background:Community-acquired pneumonia (CAP) is a major cause of mortality and morbidity among infants and children, particularly in low and middle income countries. Vitamin D, which plays a role in innate as well as adaptive immunity, is a candidate low-cost intervention as an adjunct for treatment of CAP.Methods:We searched multiple electronic databases as well as grey literature to search for randomised controlled trials (RCTs) on vitamin D as an adjunct in infants and children with CAP. We used the Cochrane methodology for assessing risk of bias and, where adequate data was available, conducted a meta-analysis using a fixed or random-effects model as applicable. We assessed overall evidence quality using the GRADE approach.Findings:We screened 272 unique papers and 25 clinical trial registry records and identified three completed and three ongoing trials based on our inclusion criteria. Two completed trials were from India and one from Afghanistan. These three RCTs included a total of 977 participants. Baseline and follow-up vitamin D status was reported in only one RCT. There was no significant effect of vitamin D noted on clinical cure rates (risk ratio (RR) 1.01; 95% confidence interval (CI) 0.91, 1.13; one study, 200 participants, low quality on GRADE), and all-cause mortality (RR 1.01; 95% CI 0.23, 4.41; three trials, 977 participants, low quality on GRADE). Pooled analyses was not possible for the outcomes of time to clinical recovery of pneumonia and total duration of hospital stay, but none of the trials which studied them demonstrated any significant effect of vitamin D on these outcomes individually.Conclusions:There is insufficient evidence available from RCTs to justify the routine use of vitamin D in infants and children with CAP currently and more research is needed to understand several issues related to this.Registration: PROSPERO ID [ 2014:CRD42014010259]