Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial
Objective Preventive zinc supplementation in the form of tablets or syrup reduces the incidence of diarrhoea and acute lower respiratory tract infections (RTI), but its effect on malaria is inconsistent. When zinc is administered with other micronutrients or foods, its effect is also uncertain. We a...
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BMJ Publishing Group
2015-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/5/9/e007828.full |
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| author | Elizabeth Yakes Jimenez Sonja Y Hess Souheila Abbeddou Kenneth H Brown Jean-Bosco Ouedraogo Jérôme W Somé Zinéwendé P Ouédraogo Rosemonde M Guissou Stephen A Vosti |
| author_facet | Elizabeth Yakes Jimenez Sonja Y Hess Souheila Abbeddou Kenneth H Brown Jean-Bosco Ouedraogo Jérôme W Somé Zinéwendé P Ouédraogo Rosemonde M Guissou Stephen A Vosti |
| author_sort | Elizabeth Yakes Jimenez |
| collection | DOAJ |
| description | Objective Preventive zinc supplementation in the form of tablets or syrup reduces the incidence of diarrhoea and acute lower respiratory tract infections (RTI), but its effect on malaria is inconsistent. When zinc is administered with other micronutrients or foods, its effect is also uncertain. We assessed the effects of different amounts and sources of zinc on the frequency of diarrhoea, malaria, fever and RTI in young children.Design, setting and populations This community-based, double-blind, placebo-controlled, cluster-randomised trial of 2435 children 9 months of age was carried out between April 2010 and July 2012 in rural southwestern Burkina Faso.Interventions Participants were randomly assigned at the concession level to receive daily 1 of 4 interventions for 9 months: (1) 20 g small-quantity lipid-based nutrient supplement (SQ-LNS) without zinc and placebo tablet, (2) 20 g SQ-LNS with 5 mg zinc and placebo tablet, (3) 20 g SQ-LNS with 10 mg zinc and placebo tablet or (4) 20 g SQ-LNS without zinc and 5 mg zinc tablet. Participants were visited weekly in their homes for morbidity surveillance for 9 months, and those with uncomplicated diarrhoea and malaria received treatment from the study field workers in the community.Main outcomes Incidence and longitudinal prevalence of diarrhoea, malaria, fever, and lower and upper RTI by intervention group.Results The incidence of diarrhoea, malaria and fever was 1.10 (±1.03 SD), 0.61 (±0.66 SD) and 1.49 (±1.12 SD) episodes per 100 child-days at risk, respectively, and did not differ by intervention group (p=0.589, p=0.856 and p=0.830, respectively). The longitudinal prevalence of acute lower RTI (0.1%; 95% IC 0.1–0.2%) and of upper RTI (7.8%; 95% IC 7.1–8.4%) did not differ among groups (p=0.234 and p=0.501, respectively).Conclusions Inclusion of 5 or 10 mg zinc in SQ-LNS and provision of 5 mg zinc dispersible tablet along with SQ-LNS had no impact on the incidence of diarrhoea, malaria and fever or the longitudinal prevalence of RTI compared with SQ-LNS without zinc in this population.Trial registration number NCT00944281. |
| format | Article |
| id | doaj-art-34505d161b884489b389390ad16ab389 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2015-09-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-34505d161b884489b389390ad16ab3892025-02-12T04:40:11ZengBMJ Publishing GroupBMJ Open2044-60552015-09-015910.1136/bmjopen-2015-007828Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trialElizabeth Yakes Jimenez0Sonja Y Hess1Souheila Abbeddou2Kenneth H Brown3Jean-Bosco Ouedraogo4Jérôme W Somé5Zinéwendé P Ouédraogo6Rosemonde M Guissou7Stephen A Vosti82 Departments of Pediatrics and Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA4 Institute for Global Nutrition, Department of Nutrition, University of California Davis, Davis, California, USA1 Department of Nutrition, University of California Davis, Davis, California, USA5The Bill and Melinda Gates Foundation, Seattle, Washington, USAInstitut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso1Institut de Recherche en Sciences de la Santé/Direction Régionale de l`Ouest, Bobo-Dioulasso, Burkina Faso1Institut de Recherche en Sciences de la Santé/Direction Régionale de l`Ouest, Bobo-Dioulasso, Burkina Faso1Institut de Recherche en Sciences de la Santé/Direction Régionale de l`Ouest, Bobo-Dioulasso, Burkina Faso4Department of Agricultural and Resource Economics, University of California, Davis, California, USAObjective Preventive zinc supplementation in the form of tablets or syrup reduces the incidence of diarrhoea and acute lower respiratory tract infections (RTI), but its effect on malaria is inconsistent. When zinc is administered with other micronutrients or foods, its effect is also uncertain. We assessed the effects of different amounts and sources of zinc on the frequency of diarrhoea, malaria, fever and RTI in young children.Design, setting and populations This community-based, double-blind, placebo-controlled, cluster-randomised trial of 2435 children 9 months of age was carried out between April 2010 and July 2012 in rural southwestern Burkina Faso.Interventions Participants were randomly assigned at the concession level to receive daily 1 of 4 interventions for 9 months: (1) 20 g small-quantity lipid-based nutrient supplement (SQ-LNS) without zinc and placebo tablet, (2) 20 g SQ-LNS with 5 mg zinc and placebo tablet, (3) 20 g SQ-LNS with 10 mg zinc and placebo tablet or (4) 20 g SQ-LNS without zinc and 5 mg zinc tablet. Participants were visited weekly in their homes for morbidity surveillance for 9 months, and those with uncomplicated diarrhoea and malaria received treatment from the study field workers in the community.Main outcomes Incidence and longitudinal prevalence of diarrhoea, malaria, fever, and lower and upper RTI by intervention group.Results The incidence of diarrhoea, malaria and fever was 1.10 (±1.03 SD), 0.61 (±0.66 SD) and 1.49 (±1.12 SD) episodes per 100 child-days at risk, respectively, and did not differ by intervention group (p=0.589, p=0.856 and p=0.830, respectively). The longitudinal prevalence of acute lower RTI (0.1%; 95% IC 0.1–0.2%) and of upper RTI (7.8%; 95% IC 7.1–8.4%) did not differ among groups (p=0.234 and p=0.501, respectively).Conclusions Inclusion of 5 or 10 mg zinc in SQ-LNS and provision of 5 mg zinc dispersible tablet along with SQ-LNS had no impact on the incidence of diarrhoea, malaria and fever or the longitudinal prevalence of RTI compared with SQ-LNS without zinc in this population.Trial registration number NCT00944281.https://bmjopen.bmj.com/content/5/9/e007828.full |
| spellingShingle | Elizabeth Yakes Jimenez Sonja Y Hess Souheila Abbeddou Kenneth H Brown Jean-Bosco Ouedraogo Jérôme W Somé Zinéwendé P Ouédraogo Rosemonde M Guissou Stephen A Vosti Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial BMJ Open |
| title | Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial |
| title_full | Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial |
| title_fullStr | Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial |
| title_full_unstemmed | Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial |
| title_short | Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial |
| title_sort | effect of zinc added to a daily small quantity lipid based nutrient supplement on diarrhoea malaria fever and respiratory infections in young children in rural burkina faso a cluster randomised trial |
| url | https://bmjopen.bmj.com/content/5/9/e007828.full |
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