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BMJ. 2002 Jun 8;324(7350):1358.

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

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1
Department of Paediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India.

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.

PMID:
12052800
PMCID:
PMC115208
[Indexed for MEDLINE]
Free PMC Article
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