Department of Pediatrics, KAHER'S JN Medical College, Nehru Nagar, Belagavi, Karnataka, 590010, India.
Indian J Pediatr. 2019 Dec;86(12):1105-1111. doi: 10.1007/s12098-019-03025-z. Epub 2019 Jul 25.
To assess the effect of vitamin D supplementation in the prevention of recurrent pneumonia in under-five children.
The present one year 8 months longitudinal, community-based randomized controlled study included a total of 100 under-five children with pneumonia. Children were divided into two groups: intervention group (Group I: standard treatment with vitamin D 300,000 IU; n = 50) and control group (Group C: standard treatment only; n = 50). As nine samples were hemolyzed, groups I and C comprised of 46 and 45 children, respectively. The children were followed up for 1 y and signs of upper respiratory tract infections (URTI), lower respiratory tract infections (LRTI), vitamin D deficiency, and vitamin D toxicity were recorded.
The male to female ratio in group C and I was 1.27:1 and 1.5:1, respectively (P = 0.420). Age, gender, birth, anthropometric and clinical characteristics, and feeding habits were not statistically significant (P > 0.05) between both the cohorts (Group C and I). Children with reduced vitamin D levels were high in group C (25) when compared to the group I (15). During all the follow-ups, the URTI and LRTI episodes, severity of pneumonia, number of hospital admissions, complications, mean episodes of LRTI, and mean duration of LRTI were comparable between group I and group C (P > 0.05).
Overall, the present study highlights that oral vitamin D (300,000 IU bolus dose quarterly) has some beneficial effect in the prevention of recurrent pneumonia in under-five children, although, not to a significant degree. Hence, it is recommended that further studies are required to demonstrate a significant effect of vitamin D in the prevention of pneumonia.
评估维生素 D 补充剂在预防 5 岁以下儿童反复肺炎中的作用。
本研究为一项为期 1 年零 8 个月的纵向、基于社区的随机对照研究,共纳入 100 例肺炎 5 岁以下儿童。将儿童分为两组:干预组(I 组:标准治疗加维生素 D 300000IU;n=50)和对照组(C 组:仅标准治疗;n=50)。由于有 9 个样本溶血,I 组和 C 组分别包含 46 名和 45 名儿童。对儿童进行了 1 年的随访,记录上呼吸道感染(URTI)、下呼吸道感染(LRTI)、维生素 D 缺乏和维生素 D 中毒的体征。
C 组和 I 组的男女比例分别为 1.27:1 和 1.5:1(P=0.420)。两组的年龄、性别、出生、人体测量学和临床特征以及喂养习惯均无统计学差异(P>0.05)。C 组维生素 D 水平降低的儿童较多(25 名),而 I 组则较少(15 名)。在所有随访中,I 组和 C 组的 URTI 和 LRTI 发作、肺炎严重程度、住院次数、并发症、LRTI 平均发作次数和 LRTI 平均持续时间均无统计学差异(P>0.05)。
总体而言,本研究强调口服维生素 D(300000IU 季剂量)对预防 5 岁以下儿童反复肺炎有一定的有益作用,尽管程度不显著。因此,建议需要进一步的研究来证明维生素 D 在预防肺炎方面的显著效果。