Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 12;1(1):CD011597.
doi: 10.1002/14651858.CD011597.pub3.

Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia

Rashmi R Das  1 , Meenu Singh  2 , Sushree S Naik  3
Affiliations

Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia

Rashmi R Das et al. Cochrane Database Syst Rev. .

Abstract

Background: Children with acute pneumonia may be vitamin D deficient. Clinical trials have found that prophylactic vitamin D supplementation decreases children's risk of developing pneumonia. Data on the therapeutic effects of vitamin D in acute childhood pneumonia are limited. This is an update of a Cochrane Review first published in 2018.

Objectives: To evaluate the efficacy and safety of vitamin D supplementation as an adjunct to antibiotics for the treatment of acute childhood pneumonia.

Search methods: We searched CENTRAL, MEDLINE, Embase, and two trial registries on 28 December 2021. We applied no language restrictions.

Selection criteria: We included randomised controlled trials (RCTs) that compared vitamin D supplementation with placebo in children (aged one month to five years) hospitalised with acute community-acquired pneumonia, as defined by the World Health Organization (WHO) acute respiratory infection guidelines. For this update, we reappraised eligible trials according to research integrity criteria, excluding RCTs published from April 2018 that were not prospectively registered in a trials registry according to WHO or Clinical Trials Registry - India (CTRI) guidelines (it was not mandatory to register clinical trials in India before April 2018).

Data collection and analysis: Two review authors independently assessed trials for inclusion and extracted data. For dichotomous data, we extracted the number of participants experiencing the outcome and the total number of participants in each treatment group. For continuous data, we used the arithmetic mean and standard deviation (SD) for each treatment group together with number of participants in each group. We used standard methodological procedures expected by Cochrane.

Main results: In this update, we included three new trials involving 468 children, bringing the total number of trials to seven, with 1601 children (631 with pneumonia and 970 with severe or very severe pneumonia). We categorised three previously included studies and three new studies as 'awaiting classification' based on the research integrity screen. Five trials used a single bolus dose of vitamin D (300,000 IU in one trial and 100,000 IU in four trials) at the onset of illness or within 24 hours of hospital admission; one used a daily dose of oral vitamin D (1000 IU for children aged up to one year and 2000 IU for children aged over one year) for five days; and one used variable doses (on day 1, 20,000 IU in children younger than six months, 50,000 IU in children aged six to 12 months, and 100,000 IU in children aged 13 to 59 months; followed by 10,000 IU/day for four days or until discharge). Three trials performed microbiological diagnosis of pneumonia, radiological diagnosis of pneumonia, or both. Vitamin D probably has little or no effect on the time to resolution of acute illness (mean difference (MD) -1.28 hours, 95% confidence interval (CI) -5.47 to 2.91; 5 trials, 1188 children; moderate-certainty evidence). We do not know if vitamin D has an effect on the duration of hospitalisation (MD 4.96 hours, 95% CI -8.28 to 18.21; 5 trials, 1023 children; very low-certainty evidence). We do not know if vitamin D has an effect on mortality rate (risk ratio (RR) 0.69, 95% CI 0.44 to 1.07; 3 trials, 584 children; low-certainty evidence). The trials reported no major adverse events. According to GRADE criteria, the evidence was of very low-to-moderate certainty for all outcomes, owing to serious trial limitations, inconsistency, indirectness, and imprecision. Three trials received funding: one from the New Zealand Aid Corporation, one from an institutional grant, and one from multigovernment organisations (Bangladesh, Sweden, and UK). The remaining four trials were unfunded.

Authors' conclusions: Based on the available evidence, we are uncertain whether vitamin D supplementation has important effects on outcomes of acute pneumonia when used as an adjunct to antibiotics. The trials reported no major adverse events. Uncertainty in the evidence is due to imprecision, risk of bias, inconsistency, and indirectness.

PubMed Disclaimer

Conflict of interest statement

RRD: has declared that they have no conflict of interest. MS: has declared that they have no conflict of interest. SSN: has declared that they have no conflict of interest.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1: Time to resolution of acute illness, Outcome 1: Time to resolution of acute illness
1.2
1.2. Analysis
Comparison 1: Time to resolution of acute illness, Outcome 2: Time to resolution of acute illness (subgroup analysis: low‐dose versus high‐dose vitamin D)
1.3
1.3. Analysis
Comparison 1: Time to resolution of acute illness, Outcome 3: Time to resolution of acute illness (subgroup analysis: oral versus parenteral vitamin D)
2.1
2.1. Analysis
Comparison 2: Duration of hospitalisation, Outcome 1: Duration of hospitalisation
2.2
2.2. Analysis
Comparison 2: Duration of hospitalisation, Outcome 2: Duration of hospitalisation (sensitivity analysis: studies with transformed data excluded)
2.3
2.3. Analysis
Comparison 2: Duration of hospitalisation, Outcome 3: Duration of hospitalisation (subgroup analysis: low‐dose versus high‐dose vitamin D)
2.4
2.4. Analysis
Comparison 2: Duration of hospitalisation, Outcome 4: Duration of hospitalisation (subgroup analysis: oral versus parenteral vitamin D)
3.1
3.1. Analysis
Comparison 3: Time to resolution of tachypnoea, Outcome 1: Time to resolution of tachypnoea
4.1
4.1. Analysis
Comparison 4: Time to resolution of lower chest indrawing, Outcome 1: Time to resolution of lower chest indrawing
5.1
5.1. Analysis
Comparison 5: Time to resolution of hypoxia, Outcome 1: Time to resolution of hypoxia
6.1
6.1. Analysis
Comparison 6: Time to resolution of fever, Outcome 1: Time to resolution of fever
7.1
7.1. Analysis
Comparison 7: Time to resolution of inability to feed or lethargy, Outcome 1: Time to resolution of inability to feed or lethargy
8.1
8.1. Analysis
Comparison 8: Treatment failure, Outcome 1: Treatment failure
9.1
9.1. Analysis
Comparison 9: Mortality rate, Outcome 1: Mortality rate
10.1
10.1. Analysis
Comparison 10: Adverse events, Outcome 1: Adverse events
See this image and copyright information in PMC

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Choudhary 2012 {published data only}
    1. Choudhary N, Gupta P. Vitamin D supplementation for severe pneumonia – a randomized controlled trial. Indian Pediatrics 2012;49(6):449-54. - PubMed
Chowdhury 2021 {published data only}
    1. Chowdhury F, Shahid AS, Tabassum M, Parvin I, Ghosh PK, Hossain MI, et al. Vitamin D supplementation among Bangladeshi children under-five years of age hospitalised for severe pneumonia: a randomised placebo controlled trial. PLOS One 2021;16(2):e0246460. [DOI: 10.1371/journal.pone.0246460] - DOI - PMC - PubMed
Gupta 2016 {published data only}
    1. Gupta P, Dewan P, Shah D, Sharma N, Bedi N, Kaur IR, et al. Vitamin D supplementation for treatment and prevention of pneumonia in under-five children: a randomized double-blind placebo controlled trial. Indian Pediatrics 2016;53(11):967-76. - PubMed
Jingi 2018 {published data only}
    1. Jingi JK, Patil SS, Desai A. Effect of vitamin D supplementation in under-5 children with pneumonia: a randomized controlled trial. Indian Journal of Child Health 2018;5(4):235-9.
Labib 2021 {published data only}
    1. Labib JR, Ibrahem SK, Ismail MM, Fatah SA, Sedrak AS, Attia MA, et al. Vitamin D supplementation and improvement of pneumonic children at a tertiary pediatric hospital in Egypt: a randomized controlled trial. Medicine (Baltimore) 2021;100(13):e25011. - PMC - PubMed
Manaseki‐Holland 2010 {published data only}
    1. Manaseki-Holland S, Qader G, Isaq Masher M, Bruce J, Zulf Mughal M, Chandramohan D, et al. Effects of vitamin D supplementation to children diagnosed with pneumonia in Kabul: a randomised controlled trial. Tropical Medicine and International Health 2010;15(10):1148-55. - PubMed
Somnath 2017 {published data only}
    1. Somnath SH, Biswal N, Chandrasekaran V, Jagdisan B, Bobby Z. Therapeutic effect of vitamin D in acute lower respiratory infection: a randomized controlled trial. Clinical Nutrition ESPEN 2017;20:24-8. - PubMed

References to studies excluded from this review

Jadhav 2021 {published data only}
    1. Jadhav S, Khanwelkar C, Jadhav A, Seshla S. Vitamin D supplementation in the prevention of recurrent acute respiratory tract infections in children aged < 5 years. Journal of Medical Sciences 2021;3:129-33.
Singh 2019 {published data only}
    1. Singh N, Kamble D, Mahantshetti NS. Effect of vitamin D supplementation in the prevention of recurrent pneumonia in under-five children. Indian Journal of Pediatrics 2019;86(12):1105-11. - PubMed
Zhou 2016 {published data only}
    1. Zhou W, Zuo X, Li J, Yu Z. Effects of nutrition intervention on the nutritional status and outcomes of pediatric patients with pneumonia. Minerva Pediatrica 2016;68(1):5-10. - PubMed

References to studies awaiting assessment

Bisht 2017 {published data only}
    1. Bisht A, Pannu MS, Singh N, Singh K, Kumar A, Neki NS. Role of vitamin D supplementation in severe pneumonia in children of age group 2 months to 5 years: a randomized controlled trial. International Journal of Current Research in Medical Sciences 2017;3(8):105-11.
Dhungel 2015 {published data only}
    1. Dhungel A, Alam MS. Efficacy of vitamin D in children with pneumonia: a randomized control trial study. Janaki Medical College Journal of Medical Sciences 2015;3(1):5-13.
Gaber 2018 {published data only}
    1. Gaber MM, Ali FA, Zaghlol KS. The effect of vitamin-D supplementation in severe pneumonia among infants. Medical Journal of Cairo University 2018;86(June):1303-9.
Rahmati 2016 {published data only}
    1. Rahmati MB, Rezapour M, Shahvari SZ. The effects of vitamin D supplementation in respiratory index of severity in children (RISC) of hospitalized patients with community-acquired pneumonia: a double-blind randomized clinical trial. Acta Health Medica 2016;1(3):60-4.
Rajshekhar 2016 {published data only}
    1. Rajshekhar CS, Vanaki R, Badakali AV, Pol RR, Yelamali BC. Efficacy of vitamin D supplementation in the treatment of severe pneumonia in children aged less than five years. International Journal of Contemporary Pediatrics 2016;3(1):96-9.
Shamaoon 2018 {published data only}
    1. Shamaoon M, Maryam, Ahsan M, Ahmad R. Vitamin D and pneumonia; role of vitamin D supplementation in children with pneumonia, a randomised control trial. Professional Medical Journal 2018;25(4):532-7. [DOI: 10.29309/TPMJ/18.4508] - DOI

References to ongoing studies

NCT02054182 {published data only}
    1. NCT02054182. Effect of vitamin D supplementation in young South African children hospitalized with acute lower respiratory infection. clinicaltrials.gov/ct2/show/NCT02054182 (first received 18 January 2014).

Additional references

Akeredolu 2021
    1. Akeredolu FD, Akuse RM, Mado SM, Yusuf R. Relationship between serum vitamin D levels and acute pneumonia in children aged 1–59 months in Nigeria. Journal of Tropical Pediatrics 2021;67(1):fmaa101. [DOI: 10.1093/tropej/fmaa101] - DOI - PubMed
Alfirevic 2021
    1. Alfirevic Z, Kellie FJ, Stewart F, Jones L, Hampson L, on behalf of Pregnancy and Childbirth Editorial Board . Identifying and handling potentially untrustworthy trials in Pregnancy and Childbirth Cochrane Reviews. Available from: pregnancy.cochrane.org/news/identifying-and-handling-potentially-untrust... (accessed 4 October 2022).
Alvarez‐Rodriguez 2012
    1. Alvarez-Rodriguez L, Lopez-Hoyos M, Garcia-Unzueta M, Amado JA, Cacho PM, Martinez-Taboada VM. Age and low levels of circulating vitamin D are associated with impaired innate immune function. Journal of Leukocyte Biology 2012;91(5):829-38. - PubMed
Atkins 2004
    1. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al, GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ 2004;328(7454):1490. - PMC - PubMed
Bang 2011
    1. Bang UC, Novovic S, Andersen AM, Fenger M, Hansen MB, Jensen JE. Variations in serum 25-hydroxy vitamin D during acute pancreatitis: an exploratory longitudinal study. Endocrine Research 2011;36(4):135-41. - PubMed
Binks 2014
    1. Binks MJ, Smith-Vaughan HC, Bar-Zeev N, Chang AB, Andrews RM. Vitamin D insufficiency among hospitalised children in the Northern Territory. Journal of Paediatrics and Child Health 2014;50(7):512-8. [DOI: 10.1111/jpc.12623] - DOI - PubMed
Chang 2014
    1. Chang CC, Cheng AC, Chang AB. Over-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults. Cochrane Database of Systematic Reviews 2014, Issue 3. Art. No: CD006088. [DOI: 10.1002/14651858.CD006088.pub4] - DOI - PMC - PubMed
Chee 2022
    1. Chee E, Huang K, Haggie S, Britton PN. Systematic review of clinical practice guidelines on the management of community acquired pneumonia in children. Paediatric Respiratory Reviews 2022;42:59-68. [DOI: 10.1016/j.prrv.2022.01.006] - DOI - PubMed
Chowdhury 2022 [pers comm]
    1. Chowdhury F. Providing data reported in median (IQR) in our trial as mean (SD) [personal communication]. Email to: RR Das 27 February 2022.
Cochrane policy – managing problematic studies
    1. Cochrane Database of Systematic Reviews: editorial policies. Cochrane policy on managing potentially problematic studies. www.cochranelibrary.com/cdsr/editorial-policies#problematic-studies (accessed 3 October 2022).
Das 2012
    1. Das RR, Singh M, Shafiq N. Short-term therapeutic role of zinc in children < 5 years of age hospitalised for severe acute lower respiratory tract infection. Paediatric Respiratory Reviews 2012;13(3):184-91. - PubMed
Das 2017 [pers comm]
    1. Das RR. Information needed regarding antibiotic therapy and hospitalisation [personal communication]. Email to: M Rezapour 8 November 2017.
Das 2021
    1. Das RR, Satapathy AK, Mukherjee A, Goyal JP, Bhat JI, Ratageri VH, et al, Members of The ATU (Acute Respiratory Infection Treatment Unit) Group. Role of clinical criteria and oxygen saturation monitoring in diagnosis of childhood pneumonia in children aged 2 to 59 months. Indian Pediatrics 2021;58(11):1024-9. [PMID: ] - PubMed
Gombart 2005
    1. Gombart AF, Borregaard N, Koeffler HP. Human cathelicidin antimicrobial peptide (CAMP) gene is a direct target of the vitamin D receptor and is strongly up-regulated in myeloid cells by 1,25-dihydroxy vitamin D₃. FASEB Journal 2005;19(9):1067-77. - PubMed
Goyal 2021
    1. Goyal JP, Kumar P, Mukherjee A, Das RR, Bhat JI, Ratageri V, et al, Acute Respiratory Infection Treatment Unit Study Group. Risk factors for the development of pneumonia and severe pneumonia in children. Indian Pediatrics 2021;58(11):1036-9. [PMID: ] - PubMed
GRADEpro GDT [Computer program]
    1. GRADEpro GDT. Version (accessed prior to 19 December 2022). Hamilton (ON): McMaster University (developed by Evidence Prime), 2015. Available from gradepro.org.
Grant 2009
    1. Grant CC, Wall CR, Crengle S, Scragg R. Vitamin D deficiency in early childhood: prevalent in the sunny South Pacific. Public Health Nutrition 2009;12(10):1893-901. - PubMed
Grey 2020
    1. Grey A, Bolland MJ, Avenell A, Klein AA, Gunsalus CK. Check for publication integrity before misconduct. Nature 2020;577(7789):167-9. - PubMed
Gupta 2016 [pers comm]
    1. Gupta P. Providing data reported in median (IQR) in our trial as mean (SD) [personal communication]. Email to: RR Das 24 April 2016.
Haider 2011a
    1. Haider BA, Lassi ZS, Ahmed A, Bhutta ZA. Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No: CD007368. [DOI: 10.1002/14651858.CD007368.pub2] - DOI - PMC - PubMed
Haider 2011b
    1. Haider BA, Lassi ZS, Bhutta ZA. Short-course versus long-course antibiotic therapy for non-severe community-acquired pneumonia in children aged 2 months to 59 months. Cochrane Database of Systematic Reviews 2011, Issue 4. Art. No: CD005976. [DOI: 10.1002/14651858.CD005976.pub2] - DOI - PubMed
Hansdottir 2008
    1. Hansdottir S, Monick MM, Hinde SL, Lovan N, Look DC, Hunninghake GW. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. Journal of Immunology 2008;181(10):7090-9. - PMC - PubMed
Heaney 2012
    1. Heaney RP. Vitamin D – baseline status and effective dose. New England Journal of Medicine 2012;367(1):77-8. - PubMed
Hemilä 2013
    1. Hemilä H, Louhiala P. Vitamin C for preventing and treating pneumonia. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No: CD005532. [DOI: 10.1002/14651858.CD005532.pub3] - DOI - PubMed
Hewison 2011
    1. Hewison M. Antibacterial effects of vitamin D. Nature Reviews Endocrinology 2011;7(6):337-45. - PubMed
Higgins 2011
    1. Higgins JP, Altman DG. Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Green S, editors(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Hollis 2011
    1. Hollis BW. Short-term and long-term consequences and concerns regarding valid assessment of vitamin D deficiency: comparison of recent food supplementation and clinical guidance reports. Current Opinion in Clinical Nutrition and Metabolic Care 2011;14(6):598-604. - PubMed
Hozo 2005
    1. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Medical Research Methodology 2005;5:13. - PMC - PubMed
IAP 2006
    1. Agarwal R, Singh V, Yewale V. RTI Facts. IAP consensus guidelines on rational management of respiratory tract infections in children. Mumbai: Indian Academyof Pediatrics (IAP) 2006.
Implementation guidance – problematic studies
    1. Cochrane Editorial and Publishing Policy Resource. Policy for managing potentially problematic studies: implementation guidance. documentation.cochrane.org/display/EPPR/Policy+for+managing+potentially+... (accessed 4 October 2022).
Janssen 2007
    1. Janssen R, Bont L, Siezen CL, Hodemaekers HM, Ermers MJ, Doornbos G, et al. Genetic susceptibility to respiratory syncytial virus bronchiolitis is predominantly associated with innate immune genes. Journal of Infectious Diseases 2007;196(6):826-34. - PubMed
Joshi 2014
    1. Joshi K, Bhatia V. Vitamin D deficiency in a tropical country – treatment and prevention in children. Indian Journal of Pediatrics 2014;81(1):84-9. - PubMed
Kelishadi 2014
    1. Kelishadi R, Ardalan G, Motlagh ME, Shariatinejad K, Heshmat R, Poursafa P, et al. National report on the association of serum vitamin D with cardiometabolic risk factors in the pediatric population of the Middle East and North Africa (MENA): the CASPIAN-III Study. Nutrition 2014;30(1):33-8. - PubMed
Kimball 2011
    1. Kimball S, Vieth R, Dosch HM, Bar-Or A, Cheung R, Gagne D, et al. Cholecalciferol plus calcium suppresses abnormal PBMC reactivity in patients with multiple sclerosis. Journal of Clinical Endocrinology and Metabolism 2011;96(9):2826-34. - PMC - PubMed
Labib 2022 [pers comm]
    1. Labib JR. Providing data reported in median (IQR) in our trial as mean (SD) [personal communication]. Email to: RR Das 27 February 2022.
Lassi 2014
    1. Lassi ZS, Kumar R, Das JK, Salam RA, Bhutta ZA. Antibiotic therapy versus no antibiotic therapy for children aged two to 59 months with WHO-defined non-severe pneumonia and wheeze. Cochrane Database of Systematic Reviews 2014, Issue 5. Art. No: CD009576. [DOI: 10.1002/14651858.CD009576.pub2] - DOI - PubMed
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JP, Green S, editors(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Liu 2006
    1. Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 2006;311(5768):1770-3. - PubMed
Lodha 2013
    1. Lodha R, Kabra SK, Pandey RM. Oral antibiotics versus parenteral antibiotics for severe pneumonia in children. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No: CD004874. [DOI: 10.1002/14651858.CD004874.pub4] - DOI - PMC - PubMed
Luo 2018
    1. Luo D, Wan X, Liu J, Tong T. Optimally estimating the sample mean from the sample size, median, mid-range, and/or mid-quartile range. Statistical Methods in Medical Research 2018;27(6):1785-805. - PubMed
Manaseki‐Holland 2012
    1. Manaseki-Holland S, Maroof Z, Bruce J, Mughal MZ, Masher MI, Bhutta ZA, et al. Effect on the incidence of pneumonia of vitamin D supplementation by quarterly bolus dose to infants in Kabul: a randomised controlled superiority trial. Lancet 2012;379(9824):1419-27. - PMC - PubMed
Manaseki‐Holland 2017 [pers comm]
    1. Manaseki-Holland. Mortality data reported in our trial [personal communication]. Email to: RR Das 4 May 2017.
Mansbach 2009
    1. Mansbach JM, Ginde AA, Camargo CA. Serum 25-hydroxyvitamin D levels among US children aged 1 to 11 years: do children need more vitamin D? Pediatrics 2009;124(5):1404-10. - PMC - PubMed
Martineau 2012
    1. Martineau AR. Bolus-dose vitamin D and prevention of childhood pneumonia. Lancet 2012;379(9824):1373-5. - PubMed
Mathew 2010
    1. Mathew JL. Vitamin A supplementation for prophylaxis or therapy in childhood pneumonia: a systematic review of randomized controlled trials. Indian Pediatrics 2010;47(3):255-61. [DOI: 10.1007/s13312-010-0042-1] - DOI - PubMed
Mathew 2015
    1. Mathew JL, Singhi S, Ray P, Hagel E, Saghafian-Hedengren S, Bansal A, et al. Etiology of community acquired pneumonia among children in India: prospective, cohort study. Journal of Global Health 2015;5(2):050418. [DOI: 10.7189/jogh.05.020418] - DOI - PMC - PubMed
McAllister 2006
    1. McAllister JC, Lane AT, Buckingham BA. Vitamin D deficiency in the San Francisco bay area. Journal of Pediatric Endocrinology and Metabolism 2006;19(3):205-8. - PubMed
Munns 2016
    1. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global consensus recommendations on prevention and management of nutritional rickets. Journal of Clinical Endocrinology and Metabolism 2016;101(2):394-415. - PMC - PubMed
Mylott 2004
    1. Mylott BM, Kump T, Bolton ML, Greenbaum LA. Rickets in the Dairy State. Wisconsin Medical Journal 2004;103(5):84-7. - PubMed
Najada 2004
    1. Najada AS, Habashneh MS, Khader M. The frequency of nutritional rickets among hospitalized infants and its relation to respiratory diseases. Journal of Tropical Pediatrics 2004;50(6):364-8. - PubMed
Nielsen 2010
    1. Nielsen NO, Skifte T, Andersson M, Wohlfahrt J, Søborg B, Koch A, et al. Both high and low serum vitamin D concentrations are associated with tuberculosis: a case-control study in Greenland. British Journal of Nutrition 2010;104(10):1487-91. - PubMed
NIH Vitamin D Fact Sheet
    1. National Institutes of Health (NIH) Office of dietary supplements. Vitamin D fact sheet for health professionals. ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ (accessed prior to 8 June 2017).
Oktaria 2021
    1. Oktaria V, Triasih R, Graham SM, Bines JE, Soenarto Y, Clarke MW, et al. Vitamin D deficiency and severity of pneumonia in Indonesian children. PLOS One 2021;16(7):e0254488. [DOI: 10.1371/journal.pone.0254488] - DOI - PMC - PubMed
Olliver 2013
    1. Olliver M, Spelmink L, Hiew J, Meyer-Hoffert U, Henriques-Normark B, Bergman P. Immunomodulatory effects of vitamin D on innate and adaptive immune responses to Streptococcus pneumoniae. Journal of Infectious Diseases 2013;208(9):1474-81. - PubMed
Perin 2022
    1. Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, et al. Global, regional, and national causes of under-5 mortality in 2000–19: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child and Adolescent Health 2022;6(2):106-15. [DOI: 10.1016/S2352-4642(21)00311-4] - DOI - PMC - PubMed
Pfeffer 2012
    1. Pfeffer PE, Hawrylowicz CM. Vitamin D and lung disease. Thorax 2012;67(11):1018-20. - PubMed
Popp 2022
    1. Popp M, Reis S, Schießer S, Hausinger RIlona, Stegemann M, Metzendorf M-I, et al. Ivermectin for preventing and treating COVID-19. Cochrane Database of Systematic Reviews 2022, Issue 6. Art. No: CD015017. [DOI: 10.1002/14651858.CD015017.pub3] - DOI - PMC - PubMed
Rajshekhar 2017 [pers comm]
    1. Rajshekhar C. Blinding and allocation concealment used in our trial [personal communication]. Email to: RR Das 3 June 2017.
Raloff 2006
    1. Raloff J. The antibiotic vitamin: deficiency in vitamin D may predispose people to infection. Science News 2006;170(20):312-7.
Review Manager 2014 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Robinson 2006
    1. Robinson PD, Högler W, Craig ME, Verge CF, Walker JL, Piper AC, et al. The re-emerging burden of rickets: a decade of experience from Sydney. Archives of Disease in Childhood 2006;91(7):564-8. - PMC - PubMed
Rudan 2008
    1. Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bulletin of the World Health Organization 2008;86(5):408-16. - PMC - PubMed
Schünemann 2011
    1. Schünemann HJ, Oxman AD, Vist GE, Higgins JP, Deeks JJ, Glasziou P, et al. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JP, Green S, editors(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Scott 2012
    1. Scott JA, Wonodi C, Moïsi JC, Deloria-Knoll M, DeLuca AN, Karron RA, et al. The definition of pneumonia, the assessment of severity, and clinical standardization in the Pneumonia Etiology Research for Child Health study. Clinical Infectious Diseases 2012;54(Suppl 2):109-16. - PMC - PubMed
Shetty 2021
    1. Shetty NS, Salvi RA, Thatte UM, Gogtay NJ. Has mandatory prospective registration of all studies brought about a change? A 1-year audit of studies registered in the Clinical Trials Registry of India [CTRI] before and after April 1, 2018. Perspectives in Clinical Research 2021;12(2):72-5. - PMC - PubMed
Somnath 2022 [pers comm]
    1. Somnath SH. Providing data reported in median (IQR) in our trial as mean (SD) [personal communication]. Email to: RR Das 4 August 2022.
Thacher 2012
    1. Thacher TD, Fischer PR, Isichei CO, Zoakah AI, Pettifor JM. Prevention of nutritional rickets in Nigerian children with dietary calcium supplementation. Bone 2012;50(5):1074-80. - PubMed
Torun 2013
    1. Torun E, Genç H, Gönüllü E, Akovalı B, Ozgen IT. The clinical and biochemical presentation of vitamin D deficiency and insufficiency in children and adolescents. Journal of Pediatric Endocrinology and Metabolism 2013;26(5-6):469-75. - PubMed
Wagner 2008
    1. Wagner CL, Greer FR. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008;122(5):1142-52. - PubMed
Wahed 2008
    1. Wahed MA, Islam MA, Khondakar P, Haque MA. Effect of micronutrients on morbidity and duration of hospital stay in childhood pneumonia. Mymensingh Medical Journal 2008;17(Suppl 2):S77-83. [PMID: ] - PubMed
Walker 2009
    1. Walker VP, Modlin RL. The vitamin D connection to pediatric infections and immune function. Pediatric Research 2009;65(5 Pt 2):R106-13. - PMC - PubMed
Wan 2014
    1. Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Medical Research Methodology 2014;14:135. - PMC - PubMed
Ward 2005
    1. Ward LM. Vitamin D deficiency in the 21st century: a persistent problem among Canadian infants and mothers. Canadian Medical Association Journal 2005;172(6):769-70. - PMC - PubMed
Ward 2007
    1. Ward LM, Gaboury I, Ladhani M, Zlotkin S. Vitamin D deficiency rickets among children in Canada. Canadian Medical Association Journal 2007;177(2):161-6. - PMC - PubMed
Weibel 2022
    1. Weibel S, Popp M, Reis S, Skoetz N, Garner P, Sydenham E. Identifying and managing problematic trials: a Research Integrity Assessment (RIA) tool for randomized controlled trials in evidence synthesis. Research Synthesis Methods 2022 August 29 [Epub ahead of print]. [DOI: 10.1002/jrsm.1599] - DOI - PMC - PubMed
Weisberg 2004
    1. Weisberg P, Scanlon KS, Li R, Cogswell ME. Nutritional rickets among children in the United States: review of cases reported between 1986 and 2003. American Journal of Clinical Nutrition 2004;8(Suppl 6):1697-705. - PubMed
White 2008
    1. White JH. Vitamin D signaling, infectious diseases, and regulation of innate immunity. Infection and Immunity 2008;76(9):3837-43. - PMC - PubMed
WHO 2005
    1. World Health Organization. Handbook: IMCI integrated management of childhood illness, 2005. Available at: apps.who.int/iris/handle/10665/42939 (accessed 5 October 2022).
WHO 2014
    1. World Health Organization . Revised WHO Classification and Treatment of Childhood Pneumonia at Health Facilities. Evidence summaries, 2014. Available at: apps.who.int/iris/bitstream/handle/10665/137319/9789241507813_eng.pdf (accessed 5 October 2022).
WHO 2018
    1. World Health Organization. International standards for clinical trial registries – Version 3.0. Available at: www.who.int/publications/i/item/international-standards-for-clinical-tri... (accessed 4 October 2022).
Wondale 2005
    1. Wondale Y, Shiferaw F, Lulseged S. A systematic review of nutritional rickets in Ethiopia: status and prospects. Ethiopian Medical Journal 2005;43(3):203-10. - PubMed
Zhang 2013
    1. Zhang W, Stoecklin E, Eggersdorfer M. A glimpse of vitamin D status in Mainland China. Nutrition 2013;29(7-8):953-7. - PubMed

References to other published versions of this review

Das 2013
    1. Das RR, Singh M, Panigrahi I, Naik SS. Vitamin D supplementation for the treatment of acute childhood pneumonia: a systematic review. ISRN Pediatrics 2013;459160:eCollection 2013. [DOI: 10.1155/2013/459160] - DOI - PMC - PubMed
Das 2015
    1. Das RR, Singh M, Naik SS. Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia. Cochrane Database of Systematic Reviews 2015, Issue 3. Art. No: CD011597. [DOI: 10.1002/14651858.CD011597] - DOI - PMC - PubMed
Das 2018
    1. Das RR, Singh M, Naik SS. Vitamin D as an adjunct to antibiotics for the treatment of acute childhood pneumonia. Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No: CD011597. [DOI: 10.1002/14651858.CD011597.pub2] - DOI - PMC - PubMed

Publication types

MeSH terms