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Vitamin A for preventing acute lower respiratory tract infections in children up to seven years of age

  1. Hengxi Chen2,
  2. Qi Zhuo3,
  3. Wei Yuan3,
  4. Juan Wang3,
  5. Taixiang Wu1,*

Editorial Group: Cochrane Acute Respiratory Infections Group

Published Online: 23 JAN 2008

Assessed as up-to-date: 29 JUN 2010

DOI: 10.1002/14651858.CD006090.pub2


How to Cite

Chen H, Zhuo Q, Yuan W, Wang J, Wu T. Vitamin A for preventing acute lower respiratory tract infections in children up to seven years of age. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD006090. DOI: 10.1002/14651858.CD006090.pub2.

Author Information

  1. 1

    West China Hospital, Sichuan University, Chinese Cochrane Centre, Chinese Clinical Trial Registry, Chinese Evidence-Based Medicine Centre, INCLEN Resource and Training Centre, Chengdu, Sichuan, China

  2. 2

    West China Second University Hospital, West China Women's and Children's Hospital, Department of Obstetrics and Gynecology, Chengdu, Sichuan, China

  3. 3

    West China Hospital, Sichuan University, Chengdu, Sichuan, China

*Taixiang Wu, Chinese Cochrane Centre, Chinese Clinical Trial Registry, Chinese Evidence-Based Medicine Centre, INCLEN Resource and Training Centre, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, 610041, China. txwutx@hotmail.com.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 23 JAN 2008

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Barreto 1994 {published data only}
  • Barreto ML, Santos LM, Assis AM, Araujo MP, Farenzena GG, Santos PA, et al. Effect of vitamin A supplementation on diarrhoea and acute lower-respiratory-tract infections in young children in Brazil. Lancet 1994;344(8917):228-31.
Bhandari 1994 {published data only}
  • Bhandari N, Bhan MK, Sazawal S. Impact of massive dose of vitamin A given to preschool children with acute diarrhoea on subsequent respiratory and diarrhoeal morbidity. BMJ 1994;309(6966):1404-7.
Dibley 1996 {published data only}
  • Dibley MJ, Sadjimin T, Kjolhede CL, Moulton LH. Vitamin A supplementation fails to reduce incidence of acute respiratory illness and diarrhea in preschool-age Indonesian children. Journal of Nutrition 1996;126(2):434-42.
Donnen 1998 {published data only}
  • Donnen P, Dramaix M, Brasseur D, Bitwe R, Vertongen F, Hennart P. Randomized placebo-controlled clinical trial of the effect of a single high dose or daily low doses of vitamin A on the morbidity of hospitalised, malnourished children. American Journal of Clinical Nutrition 1998;68(8):1254-60.
Long 2006 {published data only}
  • Long KZ, Montoya Y, Hertzmark E, Santos JI, Rosado JL. A double-blind, randomised, clinical trial of the effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections in children in Mexico City, Mexico. American Journal of Clinical Nutrition 2006;83(3):693-700.
Rahman 2001 {published data only}
  • Rahman MM, Vermund SH, Wahed MA, Fuchs GJ, Baqui AH, Alvarez JO. Simultaneous zinc and vitamin A supplementation in Bangladeshi children: randomised double blind controlled trial. BMJ 2001;323(7308):314-8.
Rahmathullah 1991 {published data only}
  • Rahmathullah L, Underwood BA, Thulasiraj RD, Milton RC. Diarrhea, respiratory infections, and growth are not affected by a weekly low-dose vitamin A supplement: a masked, controlled field trial in children in southern India. American Journal of Clinical Nutrition 1991;53(3):568-77.
Sempertegui 1999 {published data only}
  • Sempertegui F, Estrella B, Camaniero V, Betancourt V, Izurieta R, Ortiz W, et al. The beneficial effects of weekly low-dose vitamin A supplementation on acute lower respiratory infections and diarrhea in Ecuadorian children. Pediatrics 1999;104(1):e1.
Stansfield 1993 {published data only}
  • Stansfield SK, Pierre-Louis M, Lerebours G, Augustin A. Vitamin A supplementation and increased prevalence of childhood diarrhoea and acute respiratory infections. Lancet. 1993;342(8871):578-82.
VAST 1993 {published data only}

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
An 2000 {published data only}
  • An HP, Zhang HM, Li FG. 55 case of vitamin A in preventing and treating repeated respiratory tract infections. Journal of Applied Clinical Pediatrics 2000;15(1):49.
Biswas 1994 {published data only}
  • Biswas R, Biswas AB, Manna B, Bhattacharya SK, Dey R, Sarkar S. Effect of vitamin A supplementation on diarrhoea and acute respiratory tract infection in children. A double blind placebo controlled trial in a Calcutta slum community. European Journal of Epidemiology 1994;10(1):57-61.
Chang 2006 {published data only}
  • Chang AB, Torzillo PJ, Boyce NC, White AV, Stewart PM, Wheaton GR, et al. Zinc and vitamin A supplementation in Indigenous Australian children hospitalised with lower respiratory tract infection: a randomised controlled trial. Medical Journal of Australia 2006;184(3):107-12.
Cherian 2001 {published data only}
  • Cherian T, Ranjini EK, Balasubramaniam KA, Raghupati P. Vitamin A supplementation in children with recurrent respiratory infections. Indian Pediatrics 2001;38(7):771-5.
Chowdhury 2002 {published data only}
  • Chowdhury S, Kumar R, Ganguly NK, Kumar L, Walia BN. Effect of vitamin A supplementation on childhood morbidity and mortality. Indian Journal of Medical Sciences 2002;56(6):259-64.
Coutsoudis 1991 {published data only}
  • Coutsoudis A, Broughton M, Coovadia HM. Vitamin A supplementation reduces measles morbidity in young African children: a randomised, placebo-controlled, double-blind trial. American Journal of Clinical Nutrition 1991;54(5):890-5.
Coutsoudis 1995 {published data only}
  • Coutsoudis A, Bobat RA, Coovadia HM, Kuhn L, Tsai WY, Stein ZA. The effects of vitamin A supplementation on the morbidity of children born to HIV-infected women. American Journal of Public Health 1995;85(8 pt 1):1076-82.
Coutsoudis 2000 {published data only}
  • Coutsoudis A, Adhikari M, Pillay K, Kuhn L, Coovadia HM. Effect of vitamin A supplementation on morbidity of low-birth-weight neonates. South African Medical Journal 2000;90(7):730-6.
Daulaire 1992 {published data only}
Dudley 1997 {published data only}
  • Dudley L, Hussey G, Huskissen J, Kessow G. Vitamin A status, other risk factors and acute respiratory infection morbidity in children. South African Medical Journal 1997;87(1):65-70.
Fawzi 1998 {published data only}
  • Fawzi WW, Mbise RL, Fataki MR, Herrera MG, Kawau F, Hertzmark E, et al. Vitamin A supplementation and severity of pneumonia in children admitted to the hospital in Dar es Salaam, Tanzania. American Journal of Clinical Nutrition 1998;68(1):187-92.
Fawzi 1999 {published data only}
  • Fawzi WW, Mbise RL, Hertzmark E, Fataki MR, Herrera MG, Ndossi G, et al. A randomized trial of vitamin A supplements in relation to mortality among human immunodeficiency virus-infected and uninfected children in Tanzania. Pediatric Infectious Disease Journal 1999;18(2):127-33.
Fawzi 2000 {published data only}
  • Fawzi WW, Mbise R, Spiegelman D, Fataki M, Hertzmark E, Ndossi G. Vitamin A supplements and diarrhea and respiratory tract infections among children in Dar es Salaam, Tanzania. Journal of Pediatrics 2000;137(5):660-6.
Fawzi 2003 {published data only}
  • Fawzi WW, Msamanga GI, Wei R, Spiegelman D, Antelman G, Villamor E, et al. Effect of providing vitamin supplements to human immunodeficiency virus-infected, lactating mothers on the child's morbidity and CD4+ cell counts. Clinical Infectious Diseases 2003;36(8):1053-62.
Hussey 1990 {published data only}
Jiang 2009a {published data only}
  • Jiang W, Fang CX, Qu P, Liu X, Chen K, Huang HM, et al. Oral supplementation of vitamin A and E, zinc, selenite for neonates with pneumonia: a randomised placebo-controlled clinical trial of 150 cases. Acta Academiae Medicinae Militaris Tertiae 2009;31(5):450-3.
Jiang 2009b {published data only}
  • Jiang CX, Chen ZQ, Wang H, Jin JM. Study of micro-ecological preparations for preventing diarrhea secondary to pneumonia in children. Modern Journal of Integrated Traditional Chinese and Western Medicine 2009;18(20):2370-5.
Jin 2003 {published data only}
  • Jin H, Zhao TQ. Observation of the effect of Zn and vitamin A in preventing and treating recurrent respiratory tract infections in infants and children. Chinese Medical Journal of Metallurgical Industry 2003;20(4):308-9.
Julien 1999 {published data only}
  • Julien MR, Gomes A, Varandas L, Rodrigues P, Malveiro F, Aguiar P, et al. A randomized, double-blind, placebo-controlled clinical trial of vitamin A in Mozambican children hospitalized with nonmeasles acute lower respiratory tract infections. Tropical Medicine & International Health 1999;4(12):794-800.
Kao 1996 {published data only}
  • Kao Y, Yu XL, Li ZY. Observation of the effect of vitamin A as a complementary supplement for treating pneumonia in children. Zhejiang Journal of Preventive Medicine 1996;8(6):39-40.
Kartasasmita 1995 {published data only}
  • Kartasasmita C, Rosmayudi O, Demedts M, The Respiratory Diseases Working Group. Plasma retinol level, vitamin A supplementation and acute respiratory infections in children of 1-5 years old in a developing country. Tubercle and Lung Disease 1995;76(6):563-9.
Kjolhede 1995 {published data only}
Li 2005 {published data only}
  • Li YH. Evaluation of the effect of vitamin A in preventing and treating recurrent respiratory tract infections. Journal of Zhonghua Modern Paediatics 2005;2(6):541-2.
Liang 2005 {published data only}
  • Liang SY. Observation of the effect of vitamin A in preventing and treating recurrent respiratory tract infections in children. Zhonghua Clinic Medicine Research Magazine 2005;10(102):3245-6.
Liu 2003 {published data only}
  • Liu BX, Wen HY, Cao LW. 30 case of vitamin A for preventing and treating recurrent respiratory tract infections in children. Chinese Medicine of Factory and Mines 2003;16(3):207-8.
Liu 2004 {published data only}
  • Liu YL, Yang XQ, Wang LJ, Jiang LP. Clinical study on bacille calmette-guerin alone or combined with interferon gamma and vitamin A in preventing asthma children after bronchiolitis. Journal of Applied Clinical Pediatrics 2004;19(6):441-3.
Lu 2000 {published data only}
  • Lu ZX, Yang CX. Analysis of the effect of levamisol vitamin AD and vitamin E in preventing the recurrent respiratory tract infections. Journal of Huaihai Medicine 2000;18(3):230-1.
Ma 1998 {published data only}
  • Ma TF, Yang JC. Prevention of repeated infantile respiratory infection with vitamin A and zinc gluconate. Medical Journal of National Defending Forces in Southwest China 1998;8(2):92-3.
Ma 2003 {published data only}
  • Ma LZ, He ZQ. Observation of the effect of thymosin and vitamin A in preventing and treating the recurrent respiratory tract infections. Guangdong Medicine 2003;24(10):1128-9.
Mahalanabis 2002 {published data only}
  • Mahalanabis D, Chowdhury A, Jana S, Bhattacharya MK, Chakrabarti MK, Wahed MA, et al. Zinc supplementation as adjunct therapy in children with measles accompanied by pneumonia: a double-blind, randomised controlled trial. American Journal of Clinical Nutrition 2002;76(3):604-7.
Mahalanabis 2004 {published data only}
  • Mahalanabis D, Lahiri M, Paul D, Gupta S, Gupta A, Wahed MA, et al. Randomized, double-blind, placebo-controlled clinical trial of the efficacy of treatment with zinc or vitamin A in infants and young children with severe acute lower respiratory infection. American Journal of Clinical Nutrition 2004;79(3):430-6.
Nacul 1997 {published data only}
  • Nacul LC, Kirkwood BR, Arthur P, Morris SS, Magalhaes M, Fink MC. Randomised, double blind, placebo controlled clinical trial of efficacy of vitamin A treatment in non-measles childhood pneumonia. BMJ 1997;315(7107):505-10.
Nacul 1998 {published data only}
  • Nacul LC, Arthur P, Kirkwood BR, Morris SS, Cameiro AC, Benjamin AF. The impact of vitamin A supplementation given during a pneumonia episode on the subsequent morbidity of children. Tropical Medicine & International Health 1998;3(8):661-6.
Ogaro 1993 {published data only}
  • Ogaro FO, Orinda VA, Onyango FE, Black RE. Effect of vitamin A on diarrhoeal and respiratory complications of measles. Tropical and Geographical Medicine 1993;45(6):283-6.
Quinlan 1996 {published data only}
Rahman 1996 {published data only}
  • Rahman MM, Mahalanabis D, Alvarez JO, Wahed MA, Islam MA, Habte D, et al. Acute respiratory infections prevent improvement of vitamin A status in young infants supplemented with vitamin A. Journal of Nutrition 1996;126(3):628-33.
Rodriguez 2005 {published data only}
  • Rodriguez A, Hamer DH, Rivera J, Acosta M, Salgado G, Gordillo M, et al. Effects of moderate doses of vitamin A as an adjunct to the treatment of pneumonia in underweight and normal-weight children: a randomised, double-blind, placebo-controlled trial. American Journal of Clinical Nutrition 2005;82(5):1090-6.
Rosales 1994 {published data only}
  • Rosales FJ, Kjolhede C. A single 210-mumol oral dose of retinol does not enhance the immune response in children with measles. Journal of Nutrition 1994;124(9):1604-14.
Rosales 1996 {published data only}
  • Rosales FJ, Kjolhede C, Goodman S. Efficacy of a single oral dose of 200,000 IU of oil-soluble vitamin A in measles-associated morbidity. American Journal of Epidemiology 1996;143(5):413-22.
Rosales 2002 {published data only}
  • Rosales FJ. Vitamin A supplementation of vitamin a deficient measles patients lowers the risk of measles-related pneumonia in Zambian children. Journal of Nutrition 2002;132(12):3700-3.
Si 1997 {published data only}
  • Si NV, Grytter C, Vy NN, Hue NB, Pedersen FK. High dose vitamin A supplementation in the course of pneumonia in Vietnamese children. Archives of Pediatrics 1997;86(10):1052-5.
Song 2000 {published data only}
  • Song JH, Zhao AP. 50 case of Zingaite with vitamin A in preventing the respiratory tract infections. Guiding Journal of Medicine 2000;19(2):161.
Stephensen 1998 {published data only}
  • Stephensen CB, Franchi LM, Hernandez H, Campos M, Gilman RH, Alvarez JO. Adverse effects of high-dose vitamin A supplements in children hospitalized with pneumonia. Pediatrics 1998;101(5):e3.
Tan 2002 {published data only}
  • Tan CW, Wu GC, Zhou XY, Sun JP, Jiang JX, Pan H, et al. Vitamin A of prevention and assist treatment to children with diarrhea and pneumonia. Journal of Applied Clinical Pediatrics 2002;17(1):54-5.
Venkatarao 1996 {published data only}
  • Venkatarao T, Ramakrishnan R, Nair NG, Radhakrishnan S, Sundaramoorthy L, Koya PK, et al. Effect of vitamin A supplementation to mother and infant on morbidity in infancy. Indian Pediatrics 1996;33(4):279-86.
Vijayaraghavan 1990 {published data only}
Villamor 2002 {published data only}
  • Villamor E, Mbise R, Spiegelman D, Hertzmark E, Fataki M, Peterson KE. Vitamin A supplements ameliorate the adverse effect of HIV-1, malaria, and diarrheal infections on child growth. Pediatrics 2002;109(1):e6.
Villamor 2005 {published data only}
  • Villamor E, Saathoff E, Manji K, Msamanga G, Hunter DJ, Fawzi WW. Vitamin supplements, socioeconomic status, and morbidity events as predictors of wasting in HIV-infected women from Tanzania. American Journal of Clinical Nutrition 2005;82(4):857-65.
Wang 1993 {published data only}
  • Wang ZY. Observation of the effect of vitamin A in preventing the recurrent respiratory tract infections in children. Journal of Changzhi Medical College 1993;7(4):443-4.
Wang 1995 {published data only}
  • Wang ZY, Qin XQ, Zhang LL. Observation of effect of vitamin A in preventing recurrent respiratory tract infections. Journal of Clinical Pediatrics 1995;13(1):68-9.
Wang 1997 {published data only}
  • Wang L, Ruan LL. Observation of the effect of vitamin A in preventing and treating repeated respiratory tract infections in children. Zejiang Medicine 1997;19(1):53.
Wang 1999 {published data only}
  • Wang ZX, Jiang XY. Observation of the effect of vitamin A in preventing the recurrent respiratory tract infections in 60 case. Journal of Linyi Medical College 1999;21(3):239-40.
Yan 1992 {published data only}
  • Yan HC. Evaluation of effect of vitamin A supplement in preventing diarrhea and respiratory tract infectious disease in children. Health Research 1992;21(6):308-10.
Yang 1995 {published data only}
  • Yang P, Li XY. Discuss of the effect of oral small dosage of vitamin A in preventing respiratory tract infections in children. Hebei Journal of Integrated Chinese Traditional and Western Medicine 1995;4(2):15.
Yang 2003 {published data only}
  • Yang LL, Wu GY, Li DK. Observation of the effect of thymosin and vitamin A in preventing the recurrent respiratory tract infections. Journal of Chinese Physician 2003;5(9):1281-2.
Yang 2005 {published data only}
  • Yang LQ. Observation of the effect of vitamin A in preventing recurrent respiratory tract infections in children. Shiyong Pharmacy and Clinical Remedies 2005;8(4):39-40.
Zar 2003 {published data only}
  • Zar HJ. Prevention of HIV-associated respiratory illness in children in developing countries: potential benefits. International Journal of Tuberculosis and Lung Disease 2003;7(9):820-7.
Zhang 1997 {published data only}
  • Zhang JH, Qian YQ, Zhen DY. The study of the effects of massive dose vitamin A intervention to recurrent respiratory infection. Acta Nutrimenta Sinica 1997;19(3):283-6.
Zhang 1999 {published data only}
  • Zhang WX. Traditional Chinese Medicine and Western Medicine in preventing recurrent respiratory tract infections in children. Journal of Bengbu Medical College 1999;24(6):465-6.
Zhang 2000 {published data only}
  • Zhang J, Zhang M. Clinical study on preventing recurrent respiratory tract infections (RRTI) with both vitamin A and 21-SUPER-VITA. Journal of International Zhonghua Clinic Medicine 2000;1(2):92-3.
Zhang 2002 {published data only}
  • Zhang HT, Sun ZZ. Observation of 46 case of vitamin AD for preventing respiratory tract infections in children. Chinese Journal of Coal Industry Medicine 2002;5(9):948-9.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Donnen 2007 {published data only}
  • Donnen P, Sylla A, Dramaix M, Sall G, Kuakuvi N, Hennart P. Effect of daily low dose of vitamin A compared with single high dose on morbidity and mortality of hospitalised mainly malnourished children in Senegal: a randomised controlled clinical trial. European Journal of Clinical Nutrition 2007;61(12):1393-9.
Long 2007 {published data only}
  • Long KZ, Rosado JL, DuPont HL, Hertzmark E, Santos JI. Supplementation with vitamin A reduces watery diarrhoea and respiratory infections in Mexican children. British Journal of Nutrition 2007;97(2):337-43.
Swami 2007 {published data only}

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Ballow 1996
Bhandari 2002
  • Bhandari N, Bahl R, Taneja S, Strand T, Molbak K, Ulvik RJ, et al. Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum. BMJ 2002;324(7350):1358.
Bjersing 2002
Bonten 2003
Brian 2007
Dickersin 1994
Friedman 1989
Friedman 1991
  • Friedman A, Meidovsky A, Leitner G, Sklan D. Decreased resistance and immune response to Escherichia coli infection in chicks with low or high intakes of vitamin A. Journal of Nutrition 1991;121:395-400.
Grotto 2003
  • Grotto I, Mimouni M, Gdalevich M, Mimouni D. Vitamin A supplementation and childhood morbidity from diarrhea and respiratory infections: a meta-analysis. Journal of Pediatrics 2003;142(3):297-304.
Haq 1991
  • Haq R, Haiti M, Chytil F. Retinoic acid affects the expression of nuclear retinoic acid receptors in tissues of retinol-deficient rats. Proceedings of the National Academy of Sciences of the United States of America 1991;88(18):8272-6.
Hemila 2004
Higgins 2009
  • Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration. Available from www.cochrane-handbook.org 2009.
Lefebvre 2009
  • Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions. Chichester, UK: Wiley-Blackwell, 2009.
Matzinger 2002
Maurice 2006
  • Maurice ES, Moshe S, Ross AC, Benjamin C, Robert JC. Modern Nutrition in Health and Disease. 10th Edition. Lippincott Williams and Wilkins, 2006.
Murray 2001
  • World Health Organization: Murray CLJ, Lopez AD, Mathers CD, Stein C. The global burden of disease 2000 project: aims, methods and data sources. http://www.who.int/healthinfo/global_burden_disease/data_sources_methods/en/ 2001.
RevMan 2008
  • The Nordic Cochrane centre, The Cochrane Collaboration. Review Manager (RevMan). Copenhagen, Denmark: The Nordic Cochrane centre, The Cochrane Collaboration, 2008.
Ross 1996
  • Ross 1996. Vitamin A deficiency: health, survival and vision. New York: Oxford University Press, 1996.
Rudan 2004
  • Rudan I, Tomaskovic L, Boschi-Pinto C, Campbell H (on behalf of WHO Child Health Epidemiology Reference). Global estimate of the incidence of clinical pneumonia among children under five years of age. Bulletin of the World Health Organization 2004; Vol. 82:12.
Sazawal 1998
  • Sazawal S, Black RE, Jalla S, Mazumdar S, Sinha A, Bhan MK. Zinc supplementation reduces the incidence of acute lower respiratory infections in infants and preschool children: a double-blind, controlled trial. Pediatrics 1998;102:1-5.
Tateya 2007
  • Tateya I, Tateya T, Surles RL, Tanumihardjo S, Bless DM. Prenatal vitamin A deficiency causes laryngeal malformation in rats. Annals of Otology, Rhinology, and Laryngology 2007;16(10):785-92.
Tokuyama 1996
  • Tokuyama Y, Tokuyama H. Retinoids as Ig isotype-switch modulators. The role of retinoids in directing isotype switching to IgA and IgG1 (IgE) in association with IL-4 and IL-5. Cell Immunology 1996;170(2):230-4.
Walter 2001
  • Walter R, Merle A. Current diagnosis and treatment in infectious diseases. New York: McGraw-Hill, 2001.
WHO 2003
  • WHO. International Statistical Classification of Diseases and Related Health Problems. ICD-10. 10th Edition. Oxford: Oxford University Press, 2003.
Williams 2002

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Chen 2008