Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum.

Abstract:

OBJECTIVES:To evaluate the effect of daily zinc supplementation in children on the incidence of acute lower respiratory tract infections and pneumonia. DESIGN:Double masked, randomised placebo controlled trial. SETTING:A slum community in New Delhi, India. PARTICIPANTS:2482 children aged 6 to 30 months. INTERVENTIONS:Daily elemental zinc, 10 mg to infants and 20 mg to older children or placebo for four months. Both groups received single massive dose of vitamin A (100 000 IU for infants and 200 000 IU for older children) at enrollment. MAIN OUTCOME MEASURES:All households were visited weekly. Any children with cough and lower chest indrawing or respiratory rate 5 breaths per minute less than the World Health Organization criteria for fast breathing were brought to study physicians. RESULTS:At four months the mean plasma zinc concentration was higher in the zinc group (19.8 (SD 10.1) v 9.3 (2.1) micromol/l, P<0.001). The proportion of children who had acute lower respiratory tract infection during follow up was no different in the two groups (absolute risk reduction -0.2%, 95% confidence interval -3.9% to 3.6%). Zinc supplementation resulted in a lower incidence of pneumonia than placebo (absolute risk reduction 2.5%, 95% confidence interval 0.4% to 4.6%). After correction for multiple episodes in the same child by generalised estimating equations analysis the odds ratio was 0.74, 95% confidence interval 0.56 to 0.99. CONCLUSIONS:Zinc supplementation substantially reduced the incidence of pneumonia in children who had received vitamin A.

journal_name

BMJ

authors

Bhandari N,Bahl R,Taneja S,Strand T,Mølbak K,Ulvik RJ,Sommerfelt H,Bhan MK

doi

10.1136/bmj.324.7350.1358

keywords:

subject

Has Abstract

pub_date

2002-06-08 00:00:00

pages

1358

issue

7350

eissn

0959-8138

issn

1756-1833

journal_volume

324

pub_type

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