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Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial.

Abstract

BACKGROUND

Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain.

OBJECTIVE

To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence.

DESIGN

Randomized, double-blind, controlled trial.

SETTING

Rural community in South Africa.

PARTICIPANTS

THREE COHORTS: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers.

INTERVENTIONS

Children received either 1250 IU of vitamin A; vitamin A and 10 mg of zinc; or vitamin A, zinc, vitamins B1, B2, B6, B12, C, D, E, and K and copper, iodine, iron, and niacin starting at 6 months and continuing to 24 months of age. Homes were visited weekly.

OUTCOME MEASURES

Primary outcome was percentage of days of diarrhea per child by study arm within each of the three cohorts. Secondary outcomes were prevalence of upper respiratory symptoms and percentage of children who ever had pneumonia by maternal report, or confirmed by the field worker.

RESULTS

Among HIV-uninfected children born to HIV-infected mothers, median percentage of days with diarrhea was 2.3% for 49 children allocated to vitamin A; 2.5% in 47 children allocated to receive vitamin A and zinc; and 2.2% for 46 children allocated to multiple micronutrients (P = 0.852). Among HIV-uninfected children born to HIV-uninfected mothers, median percentage of days of diarrhea was 2.4% in 56 children in the vitamin A group; 1.8% in 57 children in the vitamin A and zinc group; and 2.7% in 52 children in the multiple micronutrient group (P = 0.857). Only 32 HIV-infected children were enrolled, and there were no differences between treatment arms in the prevalence of diarrhea. The prevalence of upper respiratory symptoms or incidence of pneumonia did not differ by treatment arms in any of the cohorts.

CONCLUSION

When compared with vitamin A alone, supplementation with zinc, or with zinc and multiple micronutrients, did not reduce diarrhea and respiratory morbidity in rural South African children.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00156832.

Links

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  • Authors+Show Affiliations

    ,

    Africa Centre for Health and Population Studies, University of KwaZulu Natal, Somkhele, South Africa.

    , , , , , , ,

    Source

    PloS one 2:6 2007 Jun 27 pg e541

    MeSH

    Child
    Child, Preschool
    Diarrhea
    Dietary Supplements
    Double-Blind Method
    Female
    HIV Infections
    Humans
    Incidence
    Lung Diseases
    Male
    Micronutrients
    Nutrition Disorders
    Rural Health
    South Africa
    Zinc

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    17593956

    Citation

    Luabeya, Kany-Kany Angelique, et al. "Zinc or Multiple Micronutrient Supplementation to Reduce Diarrhea and Respiratory Disease in South African Children: a Randomized Controlled Trial." PloS One, vol. 2, no. 6, 2007, pp. e541.
    Luabeya KK, Mpontshane N, Mackay M, et al. Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial. PLoS ONE. 2007;2(6):e541.
    Luabeya, K. K., Mpontshane, N., Mackay, M., Ward, H., Elson, I., Chhagan, M., ... Bennish, M. L. (2007). Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial. PloS One, 2(6), pp. e541.
    Luabeya KK, et al. Zinc or Multiple Micronutrient Supplementation to Reduce Diarrhea and Respiratory Disease in South African Children: a Randomized Controlled Trial. PLoS ONE. 2007 Jun 27;2(6):e541. PubMed PMID: 17593956.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial. AU - Luabeya,Kany-Kany Angelique, AU - Mpontshane,Nontobeko, AU - Mackay,Malanie, AU - Ward,Honorine, AU - Elson,Inga, AU - Chhagan,Meera, AU - Tomkins,Andrew, AU - Van den Broeck,Jan, AU - Bennish,Michael L, Y1 - 2007/06/27/ PY - 2007/05/03/received PY - 2007/05/09/accepted PY - 2007/6/28/pubmed PY - 2007/6/28/medline PY - 2007/6/28/entrez SP - e541 EP - e541 JF - PloS one JO - PLoS ONE VL - 2 IS - 6 N2 - BACKGROUND: Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain. OBJECTIVE: To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence. DESIGN: Randomized, double-blind, controlled trial. SETTING: Rural community in South Africa. PARTICIPANTS: THREE COHORTS: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers. INTERVENTIONS: Children received either 1250 IU of vitamin A; vitamin A and 10 mg of zinc; or vitamin A, zinc, vitamins B1, B2, B6, B12, C, D, E, and K and copper, iodine, iron, and niacin starting at 6 months and continuing to 24 months of age. Homes were visited weekly. OUTCOME MEASURES: Primary outcome was percentage of days of diarrhea per child by study arm within each of the three cohorts. Secondary outcomes were prevalence of upper respiratory symptoms and percentage of children who ever had pneumonia by maternal report, or confirmed by the field worker. RESULTS: Among HIV-uninfected children born to HIV-infected mothers, median percentage of days with diarrhea was 2.3% for 49 children allocated to vitamin A; 2.5% in 47 children allocated to receive vitamin A and zinc; and 2.2% for 46 children allocated to multiple micronutrients (P = 0.852). Among HIV-uninfected children born to HIV-uninfected mothers, median percentage of days of diarrhea was 2.4% in 56 children in the vitamin A group; 1.8% in 57 children in the vitamin A and zinc group; and 2.7% in 52 children in the multiple micronutrient group (P = 0.857). Only 32 HIV-infected children were enrolled, and there were no differences between treatment arms in the prevalence of diarrhea. The prevalence of upper respiratory symptoms or incidence of pneumonia did not differ by treatment arms in any of the cohorts. CONCLUSION: When compared with vitamin A alone, supplementation with zinc, or with zinc and multiple micronutrients, did not reduce diarrhea and respiratory morbidity in rural South African children. TRIAL REGISTRATION: ClinicalTrials.gov NCT00156832. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/17593956/Zinc_or_multiple_micronutrient_supplementation_to_reduce_diarrhea_and_respiratory_disease_in_South_African_children:_a_randomized_controlled_trial_ L2 - http://dx.plos.org/10.1371/journal.pone.0000541 DB - PRIME DP - Unbound Medicine ER -