Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2002 Jun 8;324(7350):1358.
doi: 10.1136/bmj.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

Nita Bhandari  1 , Rajiv Bahl, Sunita Taneja, Tor Strand, Kåre Mølbak, Rune Johan Ulvik, Halvor Sommerfelt, Maharaj K Bhan
Affiliations
Clinical Trial

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

Nita Bhandari et al. BMJ. .

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.

PubMed Disclaimer

Figures

Figure
Figure
Trial profile
See this image and copyright information in PMC

References

    1. Black RE. Therapeutic and preventive effects of zinc on serious childhood infectious diseases in developing countries. Am J Clin Nutr. 1998;68(suppl 2):S476–S479. - PubMed
    1. Bhutta ZA, Black RE, Brown KN, Gardner JM, Gore S, Hidayat A, et al. Zinc Investigators' Collaborative Group. Prevention of diarrhoea and pneumonia by supplementation in children in developing countries: pooled analysis of randomized controlled trials. J Pediatr. 1999;155:689–697. - PubMed
    1. Bhandari N, Bahl R, Hambidge KM, Bhan MK. Increased diarrhoeal and respiratory morbidity in association with zinc deficiency—a preliminary report. Acta Paediatr. 1996;85:148–150. - PubMed
    1. Prasad AS. Clinical, biochemical, and pharmacological role of zinc. Annu Rev Pharmacol Toxicol. 1979;19:393–426. - PubMed
    1. Fernandes G, Nair M, Onoe K, Tanaka T, Floyd R, Good RA. Impairment of cell-mediated immunity functions by dietary zinc deficiency in mice. Proc Natl Acad Sci USA. 1979;76:457–461. - PMC - PubMed

Publication types