Potential interventions for the prevention of childhood pneumonia in developing countries: a meta-analysis of data from field trials to assess the impact of vitamin A supplementation on pneumonia morbidity and mortality. The Vitamin A and Pneumonia Working Group.

A Sommer ; L Rahmathullah ; B Underwood ; R Milton ; V Reddy ; K West ; N Daulaire ; T Stukel ; G Herrera ; S Stansfield ; +9 more... D Ross ; BR Kirkwood ORCID logo ; P Arthur ; S Morris ; C Kjolhede ; M Dibley ; M Barreto ; MK Bhan ; S Gove ; (1995) Potential interventions for the prevention of childhood pneumonia in developing countries: a meta-analysis of data from field trials to assess the impact of vitamin A supplementation on pneumonia morbidity and mortality. The Vitamin A and Pneumonia Working Group. Bulletin of the World Health Organization, 73 (5). pp. 609-619. ISSN 0042-9686 https://researchonline.lshtm.ac.uk/id/eprint/4654024
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Reported are the results of a meta-analysis (12 large-scale field trials in seven countries) of the impact of vitamin A supplementation on pneumonia morbidity and mortality, undertaken as part of a wider review process of a range of possible potential interventions for the prevention of childhood pneumonia. The summary estimate of the relative risk for the impact of vitamin A supplementation on pneumonia incidence was 0.95 (95% confidence interval (CI) = 0.89, 1.01), and for pneumonia mortality, 0.98 (95% CI = 0.75, 1.28). This is in marked contrast to the substantial impact of vitamin A supplementation on all-cause mortality (combined rate ratio (RR) = 0.77, 95% CI = 0.71, 0.84), and on diarrhoea-specific and measles-specific mortality. There was no evidence for a differential impact on pneumonia mortality by age. Since the majority of pneumonia deaths occur in the first year of life, we complemented the paucity of data on pneumonia-specific mortality among this age group with a detailed examination of all-cause mortality among infants. The mortality reduction in the 6-11 month age group was consistent with that observed for older age groups (RR = 0.69; 95% CI = 0.54, 0.90), but there was no reduction for 0-5 month-olds (RR = 0.97; 95% CI = 0.73, 1.29).


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