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

• Published in: PloS one Vol. 2; no. 6; p. e541
• Main Authors: Luabeya, Kany-Kany Angelique, Mpontshane, Nontobeko, Mackay, Malanie, Ward, Honorine, Elson, Inga, Chhagan, Meera, Tomkins, Andrew, Van den Broeck, Jan, Bennish, Michael L
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27.06.2007; Public Library of Science (PLoS)
• Subjects: Anemia; Blister packs; Child; Child mortality; Child, Preschool; Children; Children & youth; Childrens health; Clinical trials; Copper; Developing countries; Diarrhea; Diarrhea - epidemiology; Diarrhea - prevention & control; Dietary Supplements; Disease control; Double-Blind Method; Enrollments; Female; Gastroenterology and Hepatology/Gastrointestinal Infections; HIV; HIV Infections - complications; Households; Human immunodeficiency virus; Humans; Incidence; Infections; Infectious diseases; Infectious Diseases/Gastrointestinal Infections; Infectious Diseases/HIV Infection and AIDS; Infectious Diseases/Respiratory Infections; Iodine; Iron; LDCs; Lung Diseases - epidemiology; Lung Diseases - prevention & control; Male; Malnutrition; Medicine; Micronutrients; Micronutrients - deficiency; Micronutrients - therapeutic use; Morbidity; Niacin; Nutrition; Nutrition Disorders - prevention & control; Nutrition research; Nutrition/Deficiencies; Nutrition/Malnutrition; Pediatric diseases; Pediatrics and Child Health/Respiratory Pediatrics; Physical growth; Pneumonia; Public Health and Epidemiology/Infectious Diseases; Randomization; Respiratory diseases; Rural areas; Rural communities; Rural Health; South Africa; Studies; Supplementation; Supplements; Vitamin A; Vitamin B12; Vitamin B6; Vitamins; Zinc; Zinc (Nutrient); Zinc - therapeutic use; South Africa; Asia; United States > US; Massachusetts; Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0000541

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. To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence. Randomized, double-blind, controlled trial. Rural community in South Africa. 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. 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. 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. 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. 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. ClinicalTrials.gov NCT00156832.