Effect of Zinc Supplementation in Children with Severe Pneumonia: A Randomised Controlled Study

Baruah, Aditi; Saikia, Hiranya

doi:10.7860/jcdr/2018/37215.12277

Cited by 4 publications

(31 citation statements)

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“…The study by Srinivasan et al 32 discussed earlier had lower mortality overall (relative risk 0.33 (95% CI 0.15 to 0.76)) and in HIV-positive patients in particular (relative risk 0.1 (95% CI 0.0 to 1.0)). The study by Baruah and Saikia 38 showed slightly lower odds of pneumonia duration more than 3 days (unadjusted OR 0.68 (95% CI 0.47 to 0.98)) and hospital stay more than 5 days (unadjusted OR 0.70 (95% CI 0.50 to 0.97)). Also, Brooks et al 35 showed improvement in recovery time (HR 0.70 (95% CI 0.51 to 0.98)) and treatment failure (HR 0.14 (95% CI 0.04 to 0.78)).…”

Section: Discussionmentioning

confidence: 88%

“…29 34 35 37 In the study by Baruah and Saikia, we used failure to recover from severe pneumonia within 3 days to define treatment failure. 38 Proportional treatment failure was comparable in both zinc and placebo groups when analysed for all patients (OR 0.95 (95% CI 0.80 to 1.14), figure 2) and only for patients with severe pneumonia (OR 0.93 (95% CI 0.75 to 1.14), figure 3).…”

Section: Resultsmentioning

confidence: 95%

“…28 34-37 In one study, the cut-off for 20 mg daily dose was 7 months. 38 Estimation on risk of bias for the included studies is presented in table 2. Four included studies had high risk of bias in one of the evaluated fields 29 32 37 38 and two other unclear risk of bias in one field each.…”

Section: Resultsmentioning

confidence: 99%

“…The study by Baruah and Saikia 38 seemed to be well designed, but outcomes of recovery and duration of hospitalisation were reported only dichotomously using a random cut-off of 3 and 5 days, respectively, and, therefore, risk of bias towards the null and questionable clinical applicability. The study by Fataki et al 29 was terminated prematurely due to difficulties in recruitment and only one-sixth of the planned sample was analysed.…”

Section: Resultsmentioning

confidence: 99%

“…This systematic review and meta-analysis identified 11 eligible trials testing the efficacy of zinc as an adjunctive treatment for pneumonia in children aged 2-60 months in LMICs. [28][29][30][31][32][33][34][35][36][37][38] Seven of these studies were deemed to have low risk of overall bias. 28 30 31 33-36 We identified two additional large RCTs with a total number of 1151 children 31 38 published since the search for the last metaanalysis was undertaken in October 2015.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of zinc as adjunctive pneumonia treatment in children aged 2 to 60 months in low-income and middle-income countries: a systematic review and meta-analysis

Brown

Kukka²,

Mårtensson³

2020

bmjpo

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BackgroundDespite advances in vaccination and case management, pneumonia remains the single largest contributor to early child mortality worldwide. Zinc has immune-enhancing properties, but its role in adjunctive treatment of pneumonia in low-income and middle-income countries (LMICs) is controversial and research still active.MethodsSystematic review and meta-analysis of randomised controlled trials of zinc and placebo in pneumonia in children aged 2 to 60 months in LMICs. Databases included MEDLINE, the Cochrane Library, EMBASE, LILACS, SciELO, the WHO portal, Scopus, Google Scholar and ClinicalTrials.gov. Inclusion criteria included accepted signs of pneumonia and clear measure of outcome. Risk of bias was independently assessed by two authors. ORs with 95% CI were used for calculating the pooled estimate of dichotomous outcomes including treatment failure and mortality. Time to recovery was expressed as HRs. Sensitivity analyses considering risk of bias and subgroup analyses for pneumonia severity were performed.ResultsWe identified 11 trials published between 2004 and 2019 fulfilling the a priori defined criteria, 7 from South Asia and 3 from Africa and 1 from South America. Proportional treatment failure was comparable in both zinc and placebo groups when analysed for all patients (OR 0.95 (95% CI 0.80 to 1.14)) and only for those with severe pneumonia (OR 0.93 (95% CI 0.75 to 1.14)). No difference was seen in mortality between zinc and placebo groups (OR 0.64 (95% CI 0.31 to 1.31)). Time to recovery from severe pneumonia did not differ between the treatment and control groups for patients with severe pneumonia (HR 1.01 (95% CI 0.89 to 1.14)). Removal of four studies with high risk of bias made no difference to the conclusions.ConclusionThere is no evidence that adjunctive zinc treatment improves recovery from pneumonia in children in LMICs.Trial registration numberCRD42019141602.

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Section: Discussionmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy of zinc as adjunctive pneumonia treatment in children aged 2 to 60 months in low-income and middle-income countries: a systematic review and meta-analysis

Brown

Kukka²,

Mårtensson³

2020

bmjpo

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A systematic review and meta‐analysis on nutritional and dietary interventions for the treatment of acute respiratory infection in pediatric patients: An EAACI taskforce

Milani,

Alberti,

Abodi

et al. 2024

Allergy

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Acute respiratory infections are a major cause of morbidity and mortality in children worldwide. Dietary and nutritional interventions, including minerals and vitamin supplementation, have been explored as potential treatments for these infections. However, the evidence on their efficacy is limited and inconclusive. This systematic review and meta‐analysis aim to provide a comprehensive summary of the available evidence on the effectiveness of dietary and nutritional interventions for treating acute respiratory tract infections in children. A systematic review was conducted according to the PRISMA 2020 guidelines in April 2022 and updated in April 2023. Clinical trials focusing on dietary or nutritional interventions, including supplementations, in children with acute respiratory tract infections were included. The selection of interventions and outcomes was based on biological plausibility. Data were extracted using a standardized form, and the risk of bias was assessed using the Cochrane Risk of Bias Tool. Meta‐analysis was performed using random‐effect models. A total of 50 studies were included in the review. Four trials were conducted in low, 32 in lower‐middle, 12 in upper‐middle, and only two in high‐income countries. The studies evaluated various dietary interventions, including zinc, vitamin A, vitamin E, vitamin D, and probiotics. The results of individual studies on the efficacy of these interventions were mixed, with some showing positive effects on clinical outcomes such as duration of symptoms, while others showed no significant impact. Meta‐analysis was conducted for zinc supplementation in children with pneumonia, and the pooled results suggested a potential limited benefit in terms of reduced hospital length of stay but not time to recovery. Meta‐analyses on vitamin D did not show any effect in children with pneumonia. This systematic review fills a critical gap in the literature by synthesizing the available evidence on the efficacy and safety of nutritional or dietary interventions for acute respiratory tract infections in children. The findings indicate no dietary or nutritional intervention can currently be recommended for the routine treatment of respiratory tract infections in children based on single supplement studies. The metanalysis suggests that zinc supplementation might have a beneficial effect on length of hospitalization in children with pneumonia. New studies are needed to establish more conclusive evidence for pediatric acute respiratory diseases especially for children living in a context of high‐income countries.

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Efektivitas Suplementasi Zink Terhadap Lama Rawat Inap pada Pasien Pneumonia Anak: A Systematic Review of Randomized Controlled Trials

Dewi,

Mayangsari,

Adnyana

2023

eum

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Zinc supplementation was reported increasing pneumonia in child outcomes, which one is the length of hospital stay, but still controversial. This review will discuss about effectivity of zinc supplementation for the length of hospital stay in children hospitalized with pneumonia in forms systematic review. Searching was performed at CENTRAL, PubMed, and ProQuest for journal published from 2015 to 2020 which evaluate the effectivity of zinc supplementation for the length of hospital stay in children hospitalized with pneumonia. This review based on writing guidelines by Cochrane Textbook of Systematic Review. There are four studies relevant to this review. All studies are blinded study. A total of 1.359 children hospitalized with pneumonia, percentage of a male around 59%. A total of 680 participants received zinc supplementation as addition for standard antibiotics. Participants were 1 to 60 months of age. All studies measure baseline serum zinc levels. Two studies reported significant results, while two other study conversely. Effectivity of zinc supplementation has not been concluded yet. Based on critical appraisal, the author attends to agree with two studies that conduct in Asia, in which the populations were similar to Indonesia. In that study found zinc supplementation effective to decreases the length of hospital stay in children hospitalized with pneumonia. There is no fatal adverse effect of zinc supplementation was reported.

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Effect of Zinc Supplementation in Children with Severe Pneumonia: A Randomised Controlled Study

Cited by 4 publications

References 0 publications

Efficacy of zinc as adjunctive pneumonia treatment in children aged 2 to 60 months in low-income and middle-income countries: a systematic review and meta-analysis

Efficacy of zinc as adjunctive pneumonia treatment in children aged 2 to 60 months in low-income and middle-income countries: a systematic review and meta-analysis

A systematic review and meta‐analysis on nutritional and dietary interventions for the treatment of acute respiratory infection in pediatric patients: An EAACI taskforce

Efektivitas Suplementasi Zink Terhadap Lama Rawat Inap pada Pasien Pneumonia Anak: A Systematic Review of Randomized Controlled Trials

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