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

Bhandari, Nita; Bahl, Rajiv; Taneja, Sunita; Strand, Tor A.; Mølbak, Kåre; Ulvik, Rune J.; Sommerfelt, Halvor; Bhan, Maharaj Kishan

doi:10.1136/bmj.324.7350.1358

Cited by 131 publications

(109 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study conducted in Ecuador showed that when children with malnourishment were supplemented with zinc for 60 days, they had a lesser incidence of respiratory infections with fever and cough. 25 Other large trials from India and Bangladesh also have confirmed a lesser incidence of ARI in children supplemented with zinc. 26 The association of Zn supplementation with the reduction in the average days of oral antibiotic usage required to treat ARIs was also studied in children with cystic fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Role of zinc supplementation in acute respiratory tract infections in children aged 2 to 60 months

Nair

Bhunia

Sharma

2017

Int J Contemp Pediatr

View full text Add to dashboard Cite

INTRODUCTIONAcute respiratory tract infections (ARI) are the most common illnesses in childhood. ARI comprises of as much as 50% of all illnesses in children less than 5 years old. It also comprises of 30% of all illnesses in children aged 5-12 years. There are many factors like infecting agents, environmental factors and host factors which determine the type of respiratory tract illnesses and their frequency.Amongst the host factors, improvement in nutrition has been considered to be the most important factor contributing to decrease in mortality and morbidity due to ARIs in children of developing countries.1 Recently, amongst all the nutrients, zinc deficiency has gained a lot of attention. Zinc deficiency is associated with impaired ABSTRACT Background: Zinc has a major role in improving immune function and decreasing morbidity in various infectious diseases like acute respiratory tract infections, diarrhoeal diseases etc. The objective of the study was to study the effect of zinc supplementation on clinical manifestations, progress of illness and duration of acute respiratory infections. Methods: A randomized double blind controlled study was conducted in the Paediatric ward of a tertiary care hospital in New Delhi in 50 children aged 2 to 60 months. Children with previous episodes of wheezing, severe malnutrition, congenital heart diseases, pneumonia, history of taking multiple micronutrient formulations or zinc for any intercurrent illnesses like diarrhoea in the previous month prior to admission and history of any known immunodeficiency disease or on any immunosuppressive medications(steroids) or anti malignancy treatment were excluded. Both placebo (syrup base) and zinc syrup (20 mg/5 mL elemental zinc as zinc sulfate) were given orally for a period of 14 days to the respective groups. Statistical analysis used: Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.). Chi-square test was done for qualitative variables and t-test was used for quantitative variables. P<0.05 was considered as statistically significant. Results: The mean age of zinc group was 22.77 months ) and that of placebo group was 22.86 months (SD -5.88) with a p value of 0.98 which was not statistically significant. There were no significant differences in the clinical features in the two groups before starting therapy or after treatment at 24, 48 and 72 hours (P>0.05). Conclusions: Zinc supplementation during episode of ARI did not show any substantial benefit in reducing duration or morbidity in children aged 2-60 months.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of zinc supplementation in acute respiratory tract infections in children aged 2 to 60 months

Nair

Bhunia

Sharma

2017

Int J Contemp Pediatr

View full text Add to dashboard Cite

show abstract

“…Zinc is a trace metal that is an important cofactor for numerous enzymes in the body and plays a key role in the immune response (22). Zinc deficiency has been implicated in the development of pneumonia in children of third world countries (23,24), and dietary zinc supplementation in these children decreases susceptibility to infection and improves overall health outcomes (25,26). Importantly, recent experimental studies have shown that alcohol-fed animals have lower zinc levels in the lung compared with controlfed animals, and dietary zinc supplementation can reverse the pulmonary immune dysfunction seen with chronic alcohol ingestion (21,27).…”

mentioning

confidence: 99%

Alcoholism Causes Alveolar Macrophage Zinc Deficiency and Immune Dysfunction

Mehta

Yeligar

Elon

et al. 2013

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Rationale: Alcohol use disorders cause oxidative stress in the lower airways and increase susceptibility to pneumonia and lung injury. Currently, no therapeutic options exist to mitigate the pulmonary consequences of alcoholism. Objectives: We recently determined in an animal model that alcohol ingestion impairs pulmonary zinc metabolism and causes alveolar macrophage immune dysfunction. The objective of this research is to determine the effects of alcoholism on zinc bioavailability and alveolar macrophage function in human subjects. Methods: We recruited otherwise healthy alcoholics (n ¼ 17) and matched control subjects (n ¼ 17) who underwent bronchoscopy for isolation of alveolar macrophages, which were analyzed for intracellular zinc, phagocytic function, and surface expression of granulocyte-macrophage colony-stimulating factor receptor; all three of these indices are decreased in experimental models. Measurements and Main Results: Alcoholic subjects had normal serum zinc, but significantly decreased alveolar macrophage intracellular zinc levels (adjusted means [SE] Conclusions: These novel clinical findings provide evidence that alcohol abuse is associated with significant zinc deficiency and immune dysfunction within the alveolar space and suggest that dietary supplementation with zinc and glutathione precursors could enhance airway innate immunity and decrease the risk for pneumonia or lung injury in these vulnerable individuals.Keywords: alcohol abuse; alveolar macrophage; zinc; immunity; glutathione Alcohol use and abuse are prevalent and impose significant health burdens in society. A recent national survey suggests that more than half of the population in the United States older than the age of 12 consumes alcohol (1) and the lifetime prevalence of alcohol abuse is 18% (2). Tragically, alcohol abuse is the third leading cause of preventable death in the United States (3), and alcoholism is associated with numerous chronic, nonfatal health implications. The overall annual cost of alcohol abuse to American society has been estimated to be upward of $200 billion (4).The consequences of alcoholism span multiple organ systems, including the heart, liver, brain, and skeletal muscle (5, 6). Among these widespread effects, alcohol abuse renders individuals susceptible to pulmonary infections and acute lung injury (7-10). We have explored potential mechanisms in experimental animal models and determined that chronic alcohol ingestion causes previously unrecognized cellular dysfunction and oxidative stress, as best reflected by significant decreases in glutathione (GSH) levels, within the alveolar space (11-14). Alveolar macrophages, which are the primary immune cell in the lower airways, exhibit impaired phagocytosis and respiratory burst generation in animal models of chronic alcohol ingestion (15, 16), and treatment with antioxidants reverses these defects (17, 18). In addition, we established that decreased signaling of granulocyte-macrophage colony-stimulating factor (GM-CSF) mediates alcohol-induced alveo...

show abstract

“…Contrastada con la de nuestro estudio, la incidencia de infección respiratoria aguda también fue menor en los niños que consumieron algún tipo de zinc y se evidenció un riesgo menor de desarrollar dicha enfermedad (RR=0,45, IC 95% : 0,247 a 0,842, p=0,016). Además de los beneficios del zinc frente al resfriado común, varios ensayos clínicos han demostrado su utilidad en el manejo adjunto de la neumonía en niños menores de cinco años tal como lo describen Black (25), Brooks (26) y Bhandari (27).…”

Section: Discussionunclassified

Efecto del zinc aminoquelado y el sulfato de zinc en la incidencia de la infección respiratoria y la diarrea en niños preescolares de centros infantiles

Sánchez¹,

Villada²,

Rojas³

et al. 2013

biomedica

View full text Add to dashboard Cite

Biomédica 2014;34:79-91 El zinc en la incidencia de la infección respiratoria y la diarrea Contribución de los autores:Juliana Sánchez y Oscar Villada: análisis estadístico, interpretación de los resultados y redacción del manuscrito. Liliana Patricia Montoya, Ana Milena Herrera, Maylen Liseth Rojas, Alejandro Díaz, Javier Chica y Cristian Vargas: análisis de los resultados. Todos los autores participaron en el diseño y ejecución del estudio, la revisión y la aprobación de la versión final del manuscrito Introducción. El déficit de zinc es común en niños de poblaciones en desarrollo. La deficiencia de zinc altera el sistema inmunológico y la resistencia a las infecciones. Objetivo. Evaluar el efecto de dos compuestos de zinc en la prevención de la infección respiratoria y la diarrea agudas. Materiales y métodos. Se llevó a cabo un ensayo comunitario triple ciego en 301 niños entre dos y cinco años de edad de centros infantiles de Medellín. Fueron seis conglomerados distribuidos aleatoriamente en tres grupos de intervención que recibieron zinc aminoquelado, sulfato de zinc y placebo durante cinco días de la semana a lo largo de 16 semanas. Se evaluaron diariamente los síntomas de infección respiratoria, diarrea aguda y efectos secundarios.Resultados. La incidencia de la infección respiratoria fue menor con el zinc aminoquelado (1,42 por 1.000 días-niño) comparado con el sulfato de zinc (1,57 por 1.000 días-niño) (RR=0,90, IC 95% : 0,382 a 2,153, p=0,999) y con el placebo (3,3 por 1.000 días-niño) (RR=0,43, IC 95% : 0,196 a 0,950, p=0,049). La incidencia de diarrea aguda con el zinc aminoquelado (0,15 por 1.000 días-niño) fue menor que con el sulfato de zinc (1,18 0,78 por 1.000 días-niño) (RR=0,20, IC 95% : 0,0043 a 1,662, p=0,361) y que la del grupo placebo (0,49 por 1.000 días-niño) (RR=0,32, IC 95% : 0,006 a 3,990, p=0,346). Conclusiones. El zinc aminoquelado tuvo mejor efecto en la disminución de la incidencia de la infección respiratoria y la diarrea agudas en niños preescolares comparado con los otros grupos de estudio. Effect of zinc amino acid chelate and zinc sulfate in the incidence of respiratory infection and diarrhea among preschool children in child daycare centers Introduction: Zinc deficiency is common in children among populations in developing areas. Zinc deficiency alters the immune system and the resistance to infections. Objective: To evaluate the effect of two zinc compounds in the prevention of acute respiratory infection and acute diarrhea. Materials and methods: Randomized triple-blind community trial with 301 children between 2-5 years of age from six child daycare centers in Medellin, Colombia. Children were distributed in three groups receiving zinc amino acid chelate, zinc sulfate and placebo five days a week for 16 weeks. Daily symptoms of respiratory infection, acute diarrhea and side effects were evaluated. Results: The incidence of respiratory infection was lower with zinc amino acid chelate (1.42 per 1,000 child-days) compared with placebo (3.3 per 1,000 child-days) (RR=0.43, ...

show abstract

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.

Cited by 131 publications

References 18 publications

Role of zinc supplementation in acute respiratory tract infections in children aged 2 to 60 months

Role of zinc supplementation in acute respiratory tract infections in children aged 2 to 60 months

Alcoholism Causes Alveolar Macrophage Zinc Deficiency and Immune Dysfunction

Efecto del zinc aminoquelado y el sulfato de zinc en la incidencia de la infección respiratoria y la diarrea en niños preescolares de centros infantiles

Contact Info

Product

Resources

About