Effect of daily zinc supplementation on child mortality in southern Nepal: a community-based, cluster randomised, placebo-controlled trial
The LancetPublished 1 October 2007
James M. Tielsch, Subarna K. Khatry, Rebecca J. Stoltzfus, Joanne Katz, Steven C. LeClerq, Ramesh Adhikari
Citations176
SJR quartileQ1
SJR score12.11
SNIP22.72
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Total mortality of children received zinc supplementation was not significantly different from that of children receiving placebo and further data are needed from other populations with endemic zinc deficiency to confirm the potential age-specific effects reported in this study.
Abstract
Total mortality of children receiving zinc supplementation was not significantly different from that of children receiving placebo. Further data are needed from other populations with endemic zinc deficiency to confirm the potential age-specific effects reported in this study.
Keywords
MedicineNursingEnvironmental Science
BiometrikaLongitudinal data analysis using generalized linear models
18,123 Citations1986Kung‐Yee Liang, Scott L. Zeger
Comparative quantification of health risks : global and regional burden of disease attributable to selected major risk factors
3,335 Citations2004Majid Ezzati, Alan D López +2 more
This book provides a comprehensive assessment of the scientific evidence on prevalence and hazards, and the resulting health effects, of a range of exposures that are known to be hazardous to human health, including childhood and maternal undernutrition, nutritional and physiological risk factors for adult health, addictive substances, sexual and reproductive health, and risks in the physical environments of households and communities.
Journal of the American Statistical AssociationThe Robust Inference for the Cox Proportional Hazards Model
2,480 Citations1989D. Y. Lin, L. J. Wei
The LancetWhere and why are 10 million children dying every year?
2,471 Citations2003Robert E. Black, Saul S. Morris +1 more
American Journal of Clinical NutritionZinc and immune function: the biological basis of altered resistance to infection
1,602 Citations1998Anuraj H. Shankar, Ananda S. Prasad
Parts of zinc biology of the immune system are explored and a biological basis for the altered host resistance to infections observed during zinc deficiency and supplementation is attempted.
The Journal of PediatricsPrevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: Pooled analysis of randomized controlled trials
732 Citations1999Zulfiqar A Bhutta, Robert E. Black +13 more
Zinc supplementation in children in developing countries is associated with substantial reductions in the rates of diarrhea and pneumonia, the 2 leading causes of death in these settings.
American Journal of Clinical NutritionEffect of supplemental zinc on the growth and serum zinc concentrations of prepubertal children: a meta-analysis of randomized controlled trials
709 Citations2002Kenneth H. Brown, Janet M Peerson +2 more
Interventions to improve children's zinc nutriture should be considered in populations at risk of zinc deficiency, especially where there are elevated rates of underweight or stunting.
BMJPubMed Central: creating an Aladdin's cave of ideas
670 Citations2001T. Delamothe
Research articles from the BMJ will be freely available from PubMed Central, the new web based repository that will archive, organise, and distribute peer reviewed reports from biomedical journals (http://pubmedcentral.nih.gov/).
PEDIATRICSZinc Supplementation Reduces the Incidence of Acute Lower Respiratory Infections in Infants and Preschool Children: A Double-blind, Controlled Trial
543 Citations1998Sunil Sazawal, Robert E. Black +4 more
DRI, Dietary reference intakes : the essential guide to nutrient requirements
539 Citations2006Jennifer J. Otten, Jennifer P. Hellwig +1 more
Dietitians, community nutritionists, nutrition educators, nutritionists working in government agencies, and nutrition students at the postsecondary level, as well as other health professionals, will find Dietary Reference Intakes: The Essential Reference for Dietary Planning and Assessment an invaluable resource.
American Journal of Clinical NutritionTherapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomized controlled trials
518 Citations2000Zulfiqar A Bhutta, Sheila M. Bird +13 more
Zinc supplementation reduces the duration and severity of acute and persistent diarrhoea and in persistent diarrhea.
Humana Press eBooksVitamin A Deficiency
304 Citations2008Keith P. West, Ian Darnton‐Hill
This chapter describes the chemical structure of vitamin A and its precursors, dietary sources, absorption, metabolism and functions, followed by discussions on the epidemiology of vitamins A deficiency, and its role in morbidity and mortality.
The LancetTopical applications of chlorhexidine to the umbilical cord for prevention of omphalitis and neonatal mortality in southern Nepal: a community-based, cluster-randomised trial
298 Citations2006Luke C. Mullany, Gary L. Darmstadt +6 more
Recommendations for dry cord care should be reconsidered on the basis of these findings that early antisepsis with chlorhexidine of the umbilical cord reduces local cord infections and overall neonatal mortality.
BMJEffect of zinc supplementation started during diarrhoea on morbidity and mortality in Bangladeshi children: community randomised trial
284 Citations2002Abdullah H Baqui, Robert E. Black +5 more
The lower rates of child morbidity and mortality with zinc treatment represent substantial benefits from a simple and inexpensive intervention that can be incorporated in existing efforts to control diarrhoeal disease.
Journal of NutritionMicronutrient Deficiencies in Early Pregnancy Are Common, Concurrent, and Vary by Season among Rural Nepali Pregnant Women
259 Citations2005Tianan Jiang, Parul Christian +3 more
Micronutrient status varied by season; it was generally best during the winter months, except for serum vitamin D concentration, which peaked during the hot summer and monsoon months, and the prevalence of deficiencies of vitamins A, E and D were 7, 25, and 14%, respectively.
American Journal of Clinical NutritionZinc supplementation increases growth and circulating insulin-like growth factor I (IGF-I) in growth-retarded Vietnamese children
244 Citations1996NX Ninh, J.T.N.M. Thissen +4 more
The study suggests that zinc deficiency may limit growth in nutritionally deprived children and suggests that the growth-stimulating effect of zinc might be mediated through changes in circulating IGF-I.
The LancetEffect of weekly zinc supplements on incidence of pneumonia and diarrhoea in children younger than 2 years in an urban, low-income population in Bangladesh: randomised controlled trial
226 Citations2005W. Abdullah Brooks, Mathuram Santosham +6 more
70 mg of zinc weekly reduces pneumonia and mortality in young children, however, compliance with weekly intake might be problematic outside a research programme.
American Journal of Clinical NutritionZinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers
218 Citations1997J A Bergado Rosado, P López +3 more
Zinc and zinc+iron supplements reduced morbidity but had no effect on growth or body composition, and the extent to which growth stunting could be reversed and the number of infectious disease episodes reduced by zinc and/or iron supplementation was assessed.
PEDIATRICSImpact of Zinc Supplementation on Morbidity From Diarrhea and Respiratory Infections Among Rural Guatemalan Children
218 Citations1997Marie T. Ruel, Juan Á. Rivera +3 more
The large impact of zinc supplementation on diarrhea incidence suggests that young, rural Guatemalan children may be zinc deficient and that zinc supplementation may be an effective intervention to improve their health and growth.
BMJEffect of zinc supplementation on malaria and other causes of morbidity in west African children: randomised double blind placebo controlled trial
208 Citations2001Olaf Müller, Heiko Becher +7 more
Zinc supplementation has no effect on morbidity from falciparum malaria in children in rural west Africa, but it does reduce morbidity associated with diarrhoea and may help to reduce mortality from all causes.
The LancetEffect of routine prophylactic supplementation with iron and folic acid on preschool child mortality in southern Nepal: community-based, cluster-randomised, placebo-controlled trial
205 Citations2006James M. Tielsch, Subarna K. Khatry +7 more
Daily supplementation of young children in southern Nepal with iron and folic acid with or without zinc has no effect on their risk of death, but might protect against diarrhoea, dysentery, and acute respiratory illness.
PEDIATRICSZinc Supplementation in Infants Born Small for Gestational Age Reduces Mortality: A Prospective, Randomized, Controlled Trial
198 Citations2001Sunil Sazawal, Robert E. Black +5 more
Zinc supplementation in small for gestational age infants can result in a substantial reduction in infectious disease mortality.
American Journal of Tropical Medicine and HygieneThe influence of zinc supplementation on morbidity due to Plasmodium falciparum: a randomized trial in preschool children in Papua New Guinea.
171 Citations2000Anuraj H. Shankar, Blaise Genton +10 more
Improved dietary zinc intake may reduce morbidity due to P. falciparum infection, and a randomized placebo-controlled trial of daily zinc supplementation in children residing in a malaria endemic region of Papua New Guinea suggests this.
American Journal of Clinical NutritionEfficacy of zinc supplementation in reducing the incidence and prevalence of acute diarrhea--a community-based, double-blind, controlled trial
156 Citations1997Sudha Sazawal, R. E. Black +4 more
Zinc supplementation had a significant effect on acute diarrheal morbidity in children > 11 mo old and in children with low plasma zinc concentrations.
PEDIATRICSSubstantial Reduction in Severe Diarrheal Morbidity by Daily Zinc Supplementation in Young North Indian Children
154 Citations2002Nita Bhandari, Rajiv Bahl +6 more
The beneficial impact of zinc was greater on the incidence of diarrhea with progressively increasing duration: episodes of diarrhea that lasted 1 to 6 days (OR): 0.92; 95% CI: 0.85-1.00), 7 to 13 days (or =14 days) and > or =14 Days (OR:0.65-0.95), and the proportion with low plasma zinc was lower (difference in proportions: -46.8% to -51.4%]).
BMJEffect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum
146 Citations2002Nita Bhandari, Rajiv Bahl +6 more
Zinc supplementation substantially reduced the incidence of pneumonia in children who had received vitamin A in a slum community in New Delhi, India.
BMJSimultaneous zinc and vitamin A supplementation in Bangladeshi children: randomised double blind controlled trial
142 Citations2001M. M Rahman, Sten H. Vermund +4 more
Combined zinc and vitamin A supplementation is more effective in reducing persistent diarrhoea and dysentery than either vitamin A or zinc alone.
American Journal of Tropical Medicine and HygieneZINC AND IRON SUPPLEMENTATION AND MALARIA, DIARRHEA, AND RESPIRATORY INFECTIONS IN CHILDREN IN THE PERUVIAN AMAZON
142 Citations2006Stephanie A. Richard, Nelly Zavaleta +4 more
Iron and zinc deficiencies should be remedied, and combined supplementation may be a good option, particularly in younger children in P. vivax malaria-endemic areas, although local endemicity and species-specific prevalence should be considered carefully when designing any supplementation program involving iron.
The LancetEffect of zinc supplementation on mortality in children aged 1–48 months: a community-based randomised placebo-controlled trial
140 Citations2007Sunil Sazawal, Robert E. Black +7 more
A meta-analysis of all studies of mortality and morbidity will help to make evidence-based recommendations for the role of zinc supplementation in public health policy to improve mortality, morbidity, growth, and development in young children.
Archives of Disease in ChildhoodRandomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea
135 Citations1997Roy Sk, A M Tomkins +5 more
Zinc supplementation is a simple, acceptable, and affordable strategy which should be considered in the management of acute diarrhoea and in prevention of growth faltering in children specially those who are malnourished.
Journal of NutritionSimultaneous Weekly Supplementation of Iron and Zinc Is Associated with Lower Morbidity Due to Diarrhea and Acute Lower Respiratory Infection in Bangladeshi Infants
134 Citations2003Abdullah H Baqui, K. Zaman +5 more
American Journal of Clinical NutritionEffect of zinc supplementation on the morbidity, immune function, and growth of low-birth-weight, full-term infants in northeast Brazil
126 Citations1998Pedro IC Lira, Ann Ashworth +1 more
It is concluded that 5 mg Zn/d is of benefit to LBW, full-term infants who only have a modest weight deficit, and zinc supplementation on these outcomes during the first 6 mo of life.
PEDIATRICSImpact of Newborn Skin-Cleansing With Chlorhexidine on Neonatal Mortality in Southern Nepal: A Community-Based, Cluster-Randomized Trial
123 Citations2007James M. Tielsch, Gary L. Darmstadt +6 more
Evidence from additional trials is needed to determine whether this inexpensive and simple intervention could improve survival significantly among low birth weight infants in settings where home delivery is common and hygiene practices are poor.
American Journal of Clinical NutritionA double-blind, randomized, clinical trial of the effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections in children in Mexico City, Mexico
101 Citations2006Kurt Z. Long, Yura Montoya +3 more
Vitamin A increases diarrheal disease and respiratory tract infections in young children in periurban areas of Mexico City and vitamin A and zinc have more heterogeneous effects in different subgroups of children.
American Journal of Clinical NutritionEffect of zinc supplementation between 1 and 6 mo of life on growth and morbidity of Bangladeshi infants in urban slums
97 Citations2002Saskia Osendarp, Mathuram Santosham +4 more
Zinc-deficient Bangladeshi infants showed improvements in growth rate and a reduced incidence of acute lower respiratory infection after zinc supplementation, and supplementation improved only biochemical zinc status.
The Journal of PediatricsRandomized, community-based trial of the effect of zinc supplementation, with and without other micronutrients, on the duration of persistent childhood diarrhea in Lima, Peru
94 Citations1999Mary E. Penny, Janet M Peerson +6 more
There was a significant reduction in the duration of persistent diarrhea in selected subgroups of zinc-supplemented ambulatory patients in this population of children in Lima, Peru.
PEDIATRICSZinc Supplementation in Malnourished Children With Persistent Diarrhea in Pakistan
92 Citations1999Zulfiqar A Bhutta, Shaikh Qamaruddin Nizami +1 more
Although there was satisfactory recovery in malnourished children with persistent diarrhea receiving the Khitchri-yogurt diet, there was no evidence of improved weight gain or acceleration of recovery from diarrhea with zinc supplementation, and the reduction in plasma copper levels in zinc-supplemented malnouredished children suggests that caution should be exercised in supplementing severely malnourshed children with zinc alone.
European Journal of Clinical NutritionZinc supplementation: effects on the growth and morbidity of undernourished Jamaican children
83 Citations1998JM Gardner, MM Witter +1 more
Zinc supplementation reduced the hospitalizations which probably reflect severity of morbidity, but did not improve growth, while the adequately nourished children were from significantly better socio-economic circumstances.
European Journal of Clinical NutritionEfficacy of combined iron and zinc supplementation on micronutrient status and growth in Vietnamese infants
82 Citations2005Jacques Berger, Nguyen Xuan Ninh +5 more
Combined iron–zinc supplementation had a positive effect on iron and zinc status in infants, however, the positive effect of zinc alone on SZn and weight would indicate a negative interaction of iron when added to zinc supplements.
Acta PaediatricaImpact of zinc supplementation on persistent diarrhoea in malnourished Bangladeshi children
71 Citations1998Roy Sk, AM Tomkins +5 more
Zinc supplementation in persistent diarrhoea significantly reduced the length of the recovery period in malnourished children and prevented a fall in body weight and serum zinc concentration, indicating that zinc is a beneficial therapeutic strategy in this high‐risk childhood illness.
PubMedEffects of short-term zinc supplementation on cellular immunity, respiratory symptoms, and growth of malnourished Equadorian children.
70 Citations1996Fernando Sempértegui, Bertha Estrella +9 more
This study supports a role for zinc in immunity, and immunity to respiratory infections, while pointing out the need for larger studies.
Acta PaediatricaImpact of zinc supplementation on diarrhoeal morbidity in rural children of West Bengal, India
43 Citations2003D N Gupta, SK Mondal +4 more
The proportion of children suffering from diarrhoea during the period was significantly lower in the zinc‐supplemented groups than in the placebo group, and diarrhoeal incidence of >4d duration was found to occur significantly less often in the supplemented groups.