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

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....

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Published inPloS 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
LanguageEnglish
Published United States Public Library of Science 27.06.2007
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Abstract 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.
AbstractList 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.
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
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.
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
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.
BACKGROUNDProphylactic 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.OBJECTIVETo determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence.DESIGNRandomized, double-blind, controlled trial.SETTINGRural community in South Africa.PARTICIPANTSTHREE COHORTS: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers.INTERVENTIONSChildren 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 MEASURESPrimary 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.RESULTSAmong 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.CONCLUSIONWhen 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 REGISTRATIONClinicalTrials.gov NCT00156832.
Audience Academic
Author Luabeya, Kany-Kany Angelique
Ward, Honorine
Elson, Inga
Tomkins, Andrew
Mackay, Malanie
Van den Broeck, Jan
Mpontshane, Nontobeko
Chhagan, Meera
Bennish, Michael L
AuthorAffiliation Institute of Clinical Effectiveness and Health Policy, Argentina
Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
4 Division of Geographic Medicine and Infectious Diseases, Tufts-New England Medical Centre, Boston, Massachusetts, United States of America
8 Centre for International Child Health, University of London, London, United Kingdom
7 Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
9 Tropical Medicine Research Institute, University of the West Indies, Kingston, Jamaica
5 Department of Chemical Pathology, University of KwaZulu-Natal, Durban, South Africa
1 Africa Centre for Health and Population Studies, University of KwaZulu Natal, Somkhele, South Africa
6 Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa
2 Church of Scotland Hospital, Tugela Ferry, South Africa
3 Department of Medical Microbiology, Nelson R. Mandela School of Medicine, Univer
AuthorAffiliation_xml – name: 5 Department of Chemical Pathology, University of KwaZulu-Natal, Durban, South Africa
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– name: Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/17593956$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright COPYRIGHT 2007 Public Library of Science
2007 Luabeya et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Luabeya et al. 2007
Copyright_xml – notice: COPYRIGHT 2007 Public Library of Science
– notice: 2007 Luabeya et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
– notice: Luabeya et al. 2007
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Principal investigator for the study: MLB. Served as Project Directors: JVdB KAL. Supervised the field work for the study: NM. Conducted the laboratory studies: MM HW IE. Designed the study: MLB AT. Wrote the grant proposal: MLB. Wrote the initial study protocol: MLB JVdB. Revised the study protocol: KAL JVdB MLB. Designed the analysis plan and conducted the analysis: JVdB MLB. Drafted the manuscript: MLB KAL JVdB. Critically reviewed and approved the manuscript: all authors.
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SSID ssj0053866
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Snippet Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in...
Background Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its...
BACKGROUNDProphylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its...
Background Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its...
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SubjectTerms 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
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Title Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial
URI https://www.ncbi.nlm.nih.gov/pubmed/17593956
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http://dx.doi.org/10.1371/journal.pone.0000541
Volume 2
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