Abstract:
OBJECTIVE:To study the effect of zinc supplementation in children under 5 years of age rom low- and middle-income countries (LMICs) on anthropometry and prevalence of malnutrition. Design:Systematic review of randomized controlled trials and cluster randomized trials. SETTING:Low- and middle-income countries. PARTICIPANTS:63 trials with zinc supplementation, incorporating data on 27372 children. Trials conducted exclusively in specifically diseased participants and in children with severe acute malnutrition were excluded. Intervention:Zinc supplementation, provided either as medicinal supplementation or through food fortification. OUTCOME MEASURES:(i) Anthropometry: weight, height, weight-for-height, mid-arm circumference, head circumference; (ii) Prevalence of malnutrition. RESULTS:There was no evidence of effect on height-for-age Z score at the end of supplementation period (25 trials; 9165 participants; MD= 0.00 Z; 95% CI -0.07, 0.07; P=0.98; moderate quality evidence) with significant heterogeneity (I² = 57%; P<0.001) related to dose and duration of zinc between trials. There was little or no effect on change in height-for-age Z score (13 trials; 8852 participants; MD= 0.11 Z; 95% CI -0.00, 0.21; P=0.05), but the heterogeneity was considerable (I²=94%; P<0.001). There was no evidence of effect on length (6303 participants; MD= 1.18 cm; 95% CI -0.63, 2.99 cm, P=0.20; moderate quality evidence; considerable heterogeneity, I²=99%) but a little positive effect on change in length (19 trials; 10783 participants; MD= 0.43 cm; 95% CI 0.16, 0.70, P=0.002; moderate quality evidence; considerable heterogeneity, I²=93%). There was no evidence of effect on weight-for-age Z score or change in weight-for-age Z score but a little positive effect on weight (19 trials; 8851 study participants; MD= 0.23 kg; 95% CI 0.03, 0.42; P=0.02; considerable heterogeneity, I²=91%) and change in weight (kg) (23 trials; 10143 study participants; MD= 0.11 kg; 95% CI 0.05, 0.17, P<0.001, substantial heterogeneity, I²=80%). There was no evidence of effect on weight-for-height Z score, and mid upper arm circumference at the end of supplementation period, but there was a little positive effect on change in MUAC from baseline (8 trials; 1724 participants; MD = 0.09 cm; 95% CI 0.01, 0.16; P=0.03; no heterogeneity, I²=0%). Head circumference in zinc supplemented group was marginally higher compared to control (2966 study participants; MD= 0.39 cm; 95% CI 0.03, 0.75; P=0.03; substantial heterogeneity, I²=67%). There was no evidence of benefit in stunting (10 trials; 11838 study participants; RR= 1.0; 95% CI 0.95, 1.06; P=0.89; Moderate Quality Evidence; no significant heterogeneity, I²=11%), wasting (7 trials; 8988 study participants; RR= 0.94; 95% CI 0.82, 1.06; P=0.31; Moderate Quality Evidence; no significant heterogeneity, I²=13%) or underweight (7 trials; 8677 study participants; RR= 1.08; 95% CI 0.96, 1.21; P=0.19; Moderate Quality Evidence; substantial heterogeneity, I²=73%). CONCLUSION:Available evidence suggests that zinc supplementation probably leads to little or no improvement in anthropometric indices and malnutrition (stunting, underweight and wasting) in children under five years of age in LMICs. Advocating zinc supplementation as a public health measure to improve growth, therefore appears unjustified in these settings with scarce resources.
journal_name
Indian Pediatrjournal_title
Indian pediatricsauthors
Gera T,Shah D,Sachdev HSsubject
Has Abstractpub_date
2019-05-15 00:00:00pages
391-406issue
5eissn
0019-6061issn
0974-7559pii
S097475591600129journal_volume
56pub_type
杂志文章abstract::There are well defined therapeutic protocols for childhood nephrotic syndrome. Appropriate therapy helps in minimizing side effects besides decreasing referrals to tertiary care centres. We have analysed the appropriateness of therapy of primary care physicians in 111 children with nephrotic syndrome referred to our I...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract::We enrolled 75 consecutive infants presenting with history of first seizure at a tertiary care hospital in New Delhi, India. Clinical and biochemical work-up for etiology, and electroencephalography were performed in all infants. Developmental assessment was done 3-month after discharge. 72% had generalized seizures, ...
journal_title:Indian pediatrics
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更新日期:2016-10-08 00:00:00
abstract::The morbidity pattern and nutritional profile was evaluated of school children who resided around Mosaboni Copper Mines and in surrounding villages of Ghatsila subdivision in Singhbhum district of Bihar State, India. A total of 1424 school children (816 boys and 608 girls) between 5-17 years old were studied. Children...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract::Twenty five asphyxiated neonates had ECG changes consistent with degree of asphyxia. Equivocal changes were found in mild asphyxia and changes suggestive of myocardial infarction were seen with severe asphyxia. In most cases, the changes reverted to normal within two weeks signifying great ability of the neonatal hear...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract::Iodine deficiency disorders (IDD) is a public health problem in India. A ban on the sale of uniodised salt for household consumption has been introduced in Rajasthan State since 1992. The present study was conducted in the district of Bharatpur, Rajasthan with the objective to assess the prevalence of iodine disorders...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2003-02-01 00:00:00
abstract::Pediatric statistics in a 50-year-old large hospital were analysed to find out any change in pediatric admission rate, morbidity and mortality and outcome of common disorders during the last four decades. Information was collected from four block years from each of the last four decades and compared. An increase of al...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1991-03-01 00:00:00
abstract::Decline in malnutrition levels has been dismal since the 1990s. We ascertained decadal trend in childhood nutritional status between 1997 and 2007 in Chandigarh, India and assessed impact of Integrated Child Development Services (ICDS) on childhood undernutrition. A total of 803 under-five children, 547 children betwe...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-011-0058-1
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:To compare the effect of Kangaroo mother care (KMC) and conventional methods of care (CMC) on growth in LBW babies (> 2000 g). STUDY DESIGN:Randomized controlled trial. SETTING:Level III NICU of a teaching institution in western India. SUBJECTS:206 neonates with birth weight < 2000 g. INTERVENTION:The sub...
journal_title:Indian pediatrics
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2008-01-01 00:00:00
abstract::Seven cases of benign form of spinal muscular atrophy were studied to evaluate the importance of detecting hand tremors, muscle fasciculation, evertion of foot and ECG tremors to distinguish these cases from muscular dystrophy. Taken in combination, diagnosis of all the seven cases was possible without the need for ap...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE:To document bone mineral density of children and adolescents with cystic fibrosis. DESIGN:Cross-sectional study. SETTING:Tertiary-care center of Northern India, July 2012 to August 2015. PARTICIPANTS:52 children aged 6-18 years with cystic fibrosis and 62 healthy controls of similar age and sex. METHODS:B...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-017-1065-7
更新日期:2017-07-15 00:00:00
abstract::Association of rotavirus gastroenteritis with histo-blood group antigens in children younger than 5 years admitted with diarrhea (n=389) was studied. Distribution of blood groups in rotavirus positive (n=96) and rotavirus negative (n=51) diarrhea gastroenteritis cases did not show any susceptibility to any blood group...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2016-07-08 00:00:00
abstract::Beta thalassemia is a common genetic disorder in Indians. Around 10,000 thala-ssemia major cases are born every year. The treatment of thalassemia major patients imposes a financial burden on the family. Much progress has been made in last 15 years in understanding of the pathogenesis of thalassemia and development of...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2006-06-01 00:00:00
abstract::A 13-year old girl presented with a decade long anemia, diffuse alveolar hemorrhage and interstistial lung disease; was eventually diagnosed as ANCA associated vasculitis. High index of suspicion is thus warranted for alternative diagnosis in chronic anemia, despite increased prevalence of infectious diseases and nutr...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-013-0042-z
更新日期:2013-02-01 00:00:00
abstract::Immune thrombocytopenic purpura (ITP) has witnessed many changes and updates over the past decade. The definitions of disease subtypes, course and response to treatment have all been standardized recently. Consequent to the lack of an international consensus management guideline, wide variations exist in treatment pra...
journal_title:Indian pediatrics
pub_type: 杂志文章,评审
doi:10.1007/s13312-012-0195-1
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To determine the role of intravenous administration of human albumin prior to blood exchange in term neonates for reduction of total serum bilirubin (TSB). DESIGN:Randomized controlled trial. SETTING:Neonatal Unit of Nemazee Hospital, affiliated with Shiraz University of Medical Sciences, southern Iran. PA...
journal_title:Indian pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1007/s13312-010-0046-x
更新日期:2010-03-01 00:00:00
abstract:: ...
journal_title:Indian pediatrics
pub_type: 评论,杂志文章
doi:
更新日期:2019-09-15 00:00:00
abstract::The present study was undertaken to find out the best simple anthropometric parameter for identifying low birth weight babies (LBW). A total of 1000 newborn babies were subjected to anthropometry within 48 hours of life. Birth weight was significantly correlated (p less than 0.001) with thigh circumference (TC), mid-a...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To determine the clinical utility of serum neutrophil gelatinase-associated lipocalin (NGAL) as an early marker of acute kidney injury in asphyxiated neonates with hypoxic ischemic encephalopathy (HIE). DESIGN:Cohort study. SETTINGS:National Intensive Care Unit of Maternity Hospital, Ain Shams University, C...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:10.1007/s13312-013-0153-6
更新日期:2013-05-08 00:00:00
abstract::Meropenem is a new carbapenem antibacterial agent with wide spectrum of activity against gram-negative, gram-positive and anaerobic organisms. It is stable against most beta-lactamases produced by gram-negative bacteria and has greatest utility in treating severe infections in hospitalized children. It has good CSF pe...
journal_title:Indian pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:2005-05-01 00:00:00
abstract::In order to evaluate clinical and bacteriological efficacy of Cefpodoxime Proxetil (CP) in typhoid fever in comparison to cefixime (CF), we assessed 140 children with suspected typhoid fever. Fulfilling inclusion criteria finally 40 culture confirmed typhoid fever were allocated in randomized double blind clinical tri...
journal_title:Indian pediatrics
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2007-11-01 00:00:00
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journal_title:Indian pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-10-01 00:00:00
abstract::To identify an inexpensive, reliable predictor of low birth weight capable of being utilized by untrained personnel, anthropometric measures were performed on 1600 newborns in Kanpur, India. This analysis indicated that, for a birth weight of 2500 g, the critical limit of calf circumference was 10.8 cm or less. Crit...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:1996-02-01 00:00:00
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journal_title:Indian pediatrics
pub_type: 杂志文章,实务指引
doi:
更新日期:2018-12-15 00:00:00
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journal_title:Indian pediatrics
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To determine the diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in children aged between 2-5 years. Design: Setting:. STUDY DESIGN:Study of diagnostic accuracy. PARTICIPANTS:A consecutive sample of 500 children with suspected Autism (delay or regression of developmental milestones, dela...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2019-10-15 00:00:00
abstract::In 2009, India contributed to over half the global cases of poliomyelitis. Many believed that India would be the last country to be polio free. India proved them wrong and was certified polio free in 2014. In January 2016, India celebrated 5 years of being polio free. One of the major reasons behind the interruption o...
journal_title:Indian pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:2016-08-07 00:00:00
abstract:OBJECTIVES:To generate evidence on the current situation of hospital care (emergency, inpatient and outpatient), for managing children presenting with diarrhea and pneumonia at 13 district hospitals in India. DESIGN:Facility-Based assessment of district hospitals. SETTINGS:13 district hospitals in four states of Biha...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2021-01-02 00:00:00
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journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To identify the pattern of congenital heart defects (CHD) in children with Down Syndrome (DS) in an Omani population, and compare it with CHD in children without DS and with historical cohorts from populations with low prevalence of consanguinity. SETTING:Open-access Paediatric Echocardiography Clinic at Sul...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2003-05-01 00:00:00
abstract::We report a case of toxic epidermal necrolysis who was successfully treated with intravenous immunoglobin and granulocyte colony-stimulating factor. He had poor prognostic factors such as extensive epidermal loss, neutropenia, acute respiratory distress syndrome and candida sepsis, but nonetheless made a complete reco...
journal_title:Indian pediatrics
pub_type: 杂志文章
doi:
更新日期:2004-04-01 00:00:00