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postgraduate thesis: A systematic review of vitamin D for prevention of acute lower respiratory infection among children

TitleA systematic review of vitamin D for prevention of acute lower respiratory infection among children
Authors
Issue Date2013
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Citation
Wu, T. [吴添舒]. (2013). A systematic review of vitamin D for prevention of acute lower respiratory infection among children. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5098950
AbstractObjective: Acute lower respiratory infection (ALRI) is the leading cause of mortality in pediatric group all around the world. Vitamin D has been demonstrated to play a possible role in the prevention of ALRI in children because of its physiological importance in the immune system. This systematic review aims to explore the protective role of vitamin D on ALRIs among children and its preventive effectiveness by synthesizing RCTs. And the other objective is to determine dosage of vitamin D with the best effect by investigating the association of different level of vitamin D supplementation with risk of ALRIs. Methods: Studies were searched through three databases PubMed, ISI Web of Knowledge and Cochran Central Register of Controlled Trials and Cochran Library databases among publication from April2003 to April 2013 with a combination of key terms. Inclusion and exclusion criteria were used to select studies. And then CONSORT guideline and JADAD scale were used to assess quality of these studies. Data on outcome measurements including health outcomes (e.g. incidence of pneumonia and influenza A, duration of recovery of pneumonia and bronchiolitis, the risk of relapse of pneumonia, the number of parent-reported ARIs); and surrogate outcomes (e.g. measuring scores of ATAQ test) were extracted and tabulated. The association with vitamin D level of risk of ALRIs were explored as well. Results: Eight RCTs were found to be relevant and adopted in this systematic review of the 796 identified articles in English or Chinese. The findings were mixed, but most studies suggested vitamin D supplementation reduced risk or illness duration of ALRIs significantly among children with different levels of vitamin D deficiency. Four studies suggested statistically significant risk reduction on incidence of repeat pneumonia (by29%, 95%CI 6% to 46%), parent-reported ARIs (by 48%, 95%CI 11% to 69), influenza A (by 42%, 95%CI 1% to 66%), and asthma exacerbation triggered by ALRIs (P= 0.029), while one study showed an insignificant outcome. For recovery events and hospitalization of ALRIs, three studies suggested statistically significant reduction on recovery time from pneumonia (P= 0.008), severe asthma (P= 0.004) and bronchiolitis (P< 0.05), and two studies suggested significant decrease on duration of hospitalization for bronchiolitis (P< 0.05) and pneumonia (P= 0.005). The increasing changes in serum 25(OH)D were consistent with the significant difference of ALRIs events between intervention and control groups. Conclusion: Overall, the evidence is insufficient to conclude that vitamin D supplementation is beneficial to all kinds of children in preventing or assistant treating ALRIs. More number of high quality, large scale and unbiased RCTs should be conducted to confirm the effectiveness of vitamin D among children in Hong Kong and different areas in mainland China.
DegreeMaster of Public Health
SubjectVitamin D - Therapeutic use
Respiratory infections in children - Prevention
Dept/ProgramPublic Health
Persistent Identifierhttp://hdl.handle.net/10722/193827

 

DC FieldValueLanguage
dc.contributor.authorWu, Tianshu-
dc.contributor.author吴添舒-
dc.date.accessioned2014-01-27T23:10:50Z-
dc.date.available2014-01-27T23:10:50Z-
dc.date.issued2013-
dc.identifier.citationWu, T. [吴添舒]. (2013). A systematic review of vitamin D for prevention of acute lower respiratory infection among children. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5098950-
dc.identifier.urihttp://hdl.handle.net/10722/193827-
dc.description.abstractObjective: Acute lower respiratory infection (ALRI) is the leading cause of mortality in pediatric group all around the world. Vitamin D has been demonstrated to play a possible role in the prevention of ALRI in children because of its physiological importance in the immune system. This systematic review aims to explore the protective role of vitamin D on ALRIs among children and its preventive effectiveness by synthesizing RCTs. And the other objective is to determine dosage of vitamin D with the best effect by investigating the association of different level of vitamin D supplementation with risk of ALRIs. Methods: Studies were searched through three databases PubMed, ISI Web of Knowledge and Cochran Central Register of Controlled Trials and Cochran Library databases among publication from April2003 to April 2013 with a combination of key terms. Inclusion and exclusion criteria were used to select studies. And then CONSORT guideline and JADAD scale were used to assess quality of these studies. Data on outcome measurements including health outcomes (e.g. incidence of pneumonia and influenza A, duration of recovery of pneumonia and bronchiolitis, the risk of relapse of pneumonia, the number of parent-reported ARIs); and surrogate outcomes (e.g. measuring scores of ATAQ test) were extracted and tabulated. The association with vitamin D level of risk of ALRIs were explored as well. Results: Eight RCTs were found to be relevant and adopted in this systematic review of the 796 identified articles in English or Chinese. The findings were mixed, but most studies suggested vitamin D supplementation reduced risk or illness duration of ALRIs significantly among children with different levels of vitamin D deficiency. Four studies suggested statistically significant risk reduction on incidence of repeat pneumonia (by29%, 95%CI 6% to 46%), parent-reported ARIs (by 48%, 95%CI 11% to 69), influenza A (by 42%, 95%CI 1% to 66%), and asthma exacerbation triggered by ALRIs (P= 0.029), while one study showed an insignificant outcome. For recovery events and hospitalization of ALRIs, three studies suggested statistically significant reduction on recovery time from pneumonia (P= 0.008), severe asthma (P= 0.004) and bronchiolitis (P< 0.05), and two studies suggested significant decrease on duration of hospitalization for bronchiolitis (P< 0.05) and pneumonia (P= 0.005). The increasing changes in serum 25(OH)D were consistent with the significant difference of ALRIs events between intervention and control groups. Conclusion: Overall, the evidence is insufficient to conclude that vitamin D supplementation is beneficial to all kinds of children in preventing or assistant treating ALRIs. More number of high quality, large scale and unbiased RCTs should be conducted to confirm the effectiveness of vitamin D among children in Hong Kong and different areas in mainland China.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.subject.lcshVitamin D - Therapeutic use-
dc.subject.lcshRespiratory infections in children - Prevention-
dc.titleA systematic review of vitamin D for prevention of acute lower respiratory infection among children-
dc.typePG_Thesis-
dc.identifier.hkulb5098950-
dc.description.thesisnameMaster of Public Health-
dc.description.thesislevelMaster-
dc.description.thesisdisciplinePublic Health-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5353/th_b5098950-
dc.date.hkucongregation2013-

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