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Vitamin A for non-measles pneumonia in childrenNi J, Wei J, Wu T
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SummaryVitamin A for non-measles pneumonia in childrenAcute respiratory infections, mostly in the form of pneumonia, are the leading cause of death in children under five years of age living in low income countries. Vitamin A supplementation has been found to reduce mortality and the severity of respiratory infections in children with measles. This review was undertaken to assess the effectiveness of vitamin A adjunctive therapy in children with non-measles respiratory infections, particularly pneumonia. We found little evidence of any benefit or harm of vitamin A adjunctive therapy in children with non-measles pneumonia.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 2, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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July 20. 2005 AbstractBackgroundAcute respiratory infections, mostly in the form of pneumonia, are the leading causes of death in children under five years of age in low income countries. Some clinical trials have demonstrated that vitamin A supplementation reduces the severity of respiratory infections and mortality in children with measles. ObjectivesTo determine whether adjunctive vitamin A is effective in children diagnosed with non-measles pneumonia. Search strategyWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 3); MEDLINE (1996 to August Week 2, 2007); EMBASE (1990 to January 2007); LILACS (6 May 2007); CINAHL (1990 to August 2007); Biological Abstracts (1990 to July 2007); Current Contents (1990 to May 2007); and the Chinese Biomedicine Database (1994 to June 2007). Selection criteriaOnly parallel-arm, randomised and quasi-randomised controlled trials (RCTs), in which children (younger than 15 years old) with non-measles pneumonia were treated with adjunctive vitamin A, were included. Data collection and analysisTwo review authors independently extracted data and assessed trial quality. Study authors were contacted for additional information. Main resultsSix trials involving 1740 children were included. There was no significant reduction in mortality associated with pneumonia in children treated with vitamin A compared to those who were not (pooled odds ratio (OR) 1.29; 95% confidence interval (CI) 0.62 to 2.69). Also, there was no statistically significant difference in duration of hospital stay (mean difference (MD) 0.08; 95% CI -0.43 to 0.59). Vitamin A was associated with a 39% reduction in antibiotic first line failure (OR 0.65; 95% CI 0.42 to 1.01). Disease severity after supplementary high-dose vitamin A was significantly worse compared with placebo. However, low-dose vitamin A significantly reduced the recurrence rate of bronchopneumonia (OR 0.12; 95% CI 0.03 to 0.46). Moderate vitamin A significantly reduced the time to remission of signs in children with normal serum retinol (> 200 ug/L). Authors' conclusionsThe evidence does not suggest a significant reduction in mortality, measures of morbidity, nor an effect on the clinical course of pneumonia with vitamin A adjunctive treatment in children with non-measles pneumonia. However, not all studies measured all outcomes, limiting the number of studies that could be incorporated into the meta-analyses, so that there may have been a lack of statistical power to detect statistically significant differences. |