Effects of vitamin D supplementation to children diagnosed with pneumonia in Kabul: a randomised controlled trial

Randomized controlled trial in young children with pneumonia treated at Maywand Teaching Hospital in Kabul, Afghanistan. The active vitamin D arm included 224 participants aged 1 week to 3 years; children with rickets, severe comorbidity, very severe pneumonia, or wheeze were excluded.

Children in the active arm received a single oral dose of vitamin D3 (cholecalciferol) 100,000 IU, prepared in 1 mL of olive oil and given by syringe, in addition to standard antibiotic treatment. The regimen was a one-time administration rather than a repeated course.

Single-dose vitamin D3 did not shorten the initial pneumonia episode, but it reduced repeat pneumonia within 90 days in this high-deficiency setting. Recovery within 24 h was similar, with 13 (6%) versus 11 (5%) and mean time to recovery of 4.74 days versus 4.98 days (P = 0.17). Repeat pneumonia occurred in 92/204 (45%) versus 122/211 (58%), with relative risk 0.78 (95% CI 0.64 to 0.94; P = 0.01) and time to repeat episode hazard ratio 0.71 (95% CI 0.53 to 0.95; P = 0.02). No adverse events were observed; three children died during follow-up.

The trial was conducted at a single hospital in Kabul and enrolled young children from a high-risk, likely vitamin D deficient population, which limits generalizability. Follow-up was only 90 days, and the intervention did not improve the index illness duration. Some outcome denominators were smaller than the active-arm randomized N, indicating missing data or incomplete follow-up.