Abstract
(1) Background: vitamin A deficiency (VAD) is highly prevalent in children living in poor conditions. It has been suggested that vitamin A supplementation (VAS) may reduce the risk of acute respiratory tract infections (ARTI). Our study provides updates on the effects of oral VAS (alone) in children on ARTI and further explores the effect on interesting subgroups. (2) Methods: eight databases were systematically searched from their inception until 5 July 2021. The assessments of inclusion criteria, extraction of data, and data synthesis were carried out independently by two reviewers. (3) Results: a total of 26 randomized trials involving 50,944 participants fulfilled the inclusion criteria. There was no significant association of VAS with the incidence of ARTI compared with the placebo (RR 1.03, 95% CI 0.92 to 1.15). Subgroup analyses showed that VAS higher than WHO recommendations increased the incidence of ARTI by 13% (RR 1.13, 95% CI 1.07 to 1.20), and in the high-dose intervention group, the incidence rate among well-nourished children rose by 66% (RR 1.66, 95% CI 1.30 to 2.11). (4) Conclusions: no more beneficial effects were seen with VAS in children in the prevention or recovery of acute respiratory infections. Excessive VAS may increase the incidence of ARTI in children with normal nutritional status.
Highlights
Acute respiratory tract infection (ARTI), including acute upper respiratory infection (AURI), i.e., common cold, pharyngitis, and tonsillitis and acute lower respiratory infection (ALRI), i.e., pneumonia and bronchitis [1] are a major cause of morbidity and mortality worldwide [2]
There was no significant association of vitamin A supplementation (VAS) with the incidence of ARTI compared with the placebo (RR 1.03, 95% confidence intervals (CI) 0.92 to 1.15)
Subgroup analyses showed that VAS higher than WHO recommendations increased the incidence of ARTI by 13% (RR 1.13, 95% CI 1.07 to 1.20), and in the high-dose intervention group, the incidence rate among well-nourished children rose by 66% (RR 1.66, 95% CI 1.30 to 2.11)
Summary
Acute respiratory tract infection (ARTI), including acute upper respiratory infection (AURI), i.e., common cold, pharyngitis, and tonsillitis and acute lower respiratory infection (ALRI), i.e., pneumonia and bronchitis [1] are a major cause of morbidity and mortality worldwide [2]. In 2008, an estimated 8.795 million deaths occurred among children under the age of 5 in the world, of which 68% were caused by infectious diseases [3]. ARTI was responsible for an estimated 2.56 million deaths worldwide in 2017 and was the most common cause of death among children under 5 years old [4]. Numerous mechanisms and clinical data suggest that vitamins, including vitamins A, B6, B12, C, D, and E, play important and complementary roles in supporting the immune system [6]. Inadequate intake of these nutrients is common, leading to a decline in resistance to infection, thereby increasing the burden of disease
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