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Table 4 Summary of evidence and recommendations for single interventions

From: Supporting recommendations for childhood preventive interventions for primary health care: elaboration of evidence synthesis and lessons learnt

  Evidence      Recommendations  
Intervention Type of interventions Types of studies Date Findings Certainty of the evidencea Recommendations across reviewed documents Strength of recommendationsa
Vitamin D Effectiveness of vit D supplementation for preventing nutritional rickets in term born children (clinical and radiological outcomes) SR (4 trials, 1700 participants)
Surveillance data
SR 2007
Studies 1994 to 2004
Vit D supplementation prevents from developing rickets High quality evidence according to European global consensus - WHO: acknowledges effectiveness, but requests further research for specific recommendations
- PrevInfad, CDC, NICE, Global European consensus recommend
- WHO: category 2 intervention
- PrevInfad: Grade B
- European global consensus: strong
Effectiveness of vit D supplementation for improving bone mineral density (BMD) SR (6 RCTs, 884 participants) SR 2010
Studies 2004 to 2008
No effect on total body BMD or lumbar spinal BMD.
Probably no effect on hip BMD and forearm BMD.
High certainty evidence
Moderate certainty evidence
Vitamin K Effectiveness of vit K for preventing HDN (clinical outcome: bleeding) SR (2 RCTs, only for classical HDN and IM) Studies 1960’s Effective Not graded by Cochrane authors but referred as ‘poor methodological quality’
Graded as low-moderate by WHO
Recommended by all institutions Strong (WHO, PrevInfad)
Effectiveness of vit K for preventing HDN (biochemical outcomes) SR (5 RCTs, only for classical HDN, IM and oral) Studies 1990’s Effective
Intramuscular versus oral No RCT
National surveillance data
Last 3 decades Both intramuscular and oral effective Not applicable
Fluoride Toothbrushing for preventing dental caries SRs SR 2019
Studies 1982 to 2014
Effective Moderate Recommended by all institutions B recommendation (USPSTF); strength of the evidence I (NHS)
  1. Abbreviations: BMD Bone mineral density, CDC Centers of Disease Control and Prevention, HDN Haemorrhage disease of the newborn, NHS National Health Service, NICE National Institute for Health and Care Excellence, RCT Randomized control trial, SR Systematic review, USPSTF United States Preventive Services Task Force, vit Vitamin
  2. aAs per the authors of the retrieved documents