14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
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Final Abstract Number: 80.019
Session: Pediatric and Perinatal Infections
Date: Friday, March 12, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
RCT Methodology, population profile and pneumonia rates in socio-economically deprived infants
of Kabul: Data from a RCT investigating the effects of vitamin D supplementation on the
incidence of infant pneumonia
Z. Zabihullah 1 , S. Manaseki-Holland 2 , D. Chandramohan 3 , Z. Bhutta 4 , Z. Mughal 5
1 London School of Hygiene and Tropical Medicine, London, London, United Kingdom, 2 University
of Birmingham, Birmingham, Birmingham, United Kingdom, 3 London School and Hygiene and
Tropical Medicine, London, London, United Kingdom, 4 The Aga Khan University, Karachi,
Pakistan, 5 Saint Mary's Hospital for Women and Children, Marchester, Manchester, United
Kingdom
Background:
Approximately 150 million children under-5 suffer from pneumonia each year worldwide and
South-east Asia has the highest incidence of pneumonia (0.36 episodes per child-year). Two
hospital-based case-control studies from Ethiopia and India suggest that vitamin D deficiency
may substantially increase the risk of severe pneumonia among children under-5. In Afghanistan
Dietary intake of vitamin D is low and exposure to sunlight is also limited due to widespread use
of Burqua. Thus it was hypothesized that supplementation of vitamin D would reduce the
incidence of pneumonia in young children particularly in areas where vitamin D deficiency is
common.
Methods: Study Design: Double blind placebo controlled trial
Setting: 4 urban districts in Kabul, Afghanistan with a socio-economically deprived population
living in overcrowded housing.
Subjects: 3048 children(half taking vitamin D and half placebo) aged 1-11 months at recruitment
(Nov-Dec 2007) followed up for 18 months through active and passive surveillances.
Intervention: 3-monthly oral 100,000IU vitamin D versus Placebo (olive oil).
Analysis: Rate ratio for episodes of pneumonia was calculated for the whole population using
survival analysis. Kaplan Meier plots display the survival curves. Covariates in the models control
for potential confounders and/or interactions
Results: Socio-demographic Profile Sex ratio of infants was balanced (males 52.2% and females
47.8%).The mean age of children was 6.5 months (SD 3.1) at recruitment.
Incidence rate of Clinical Pneumonia (IMCI definition): As the trial is not complete yet, the data for
the first 12 months is used for this presentation The incidence rate (95% CI) for first episode of
simple pneumonia was 1.5/child year (1.5,1.6), while for repeat episodes was 1.7 (1.7,1.8). The
incidence rate of the first episode of severe pneumonia was 0.1/child year (0.09, 0.12) and for
repeat episodes was 0.1 (0.11, 0.13). The incidence rate of all episodes of pneumonia was 1.8
(1.7, 1.8).
Conclusion: RCT with 18 months follow up amongst socio-economically deprived population in
Kabul can be successfully implemented. Lessons learned will be shared in the presentation. The
incidence rate for pneumonia seems high compared to South Asia rates