Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months
| Autor: | Andrew Tomkins, Kany-Kany A. Luabeya, Nontobeko Mpontshane, Michael L. Bennish, Meera Chhagan, Jan Van den Broeck |
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| Přispěvatelé: | Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Male
Vitamin Pediatrics medicine.medical_specialty 030309 nutrition & dietetics Anemia HIV Infections Growth law.invention South Africa 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Double-Blind Method Randomized controlled trial law medicine Humans Micronutrients 030212 general & internal medicine Vitamin A 2. Zero hunger 0303 health sciences Anthropometry Vitamin A Deficiency business.industry lcsh:Public aspects of medicine Public Health Environmental and Occupational Health Retinol Infant lcsh:RA1-1270 medicine.disease Micronutrient 3. Good health Vitamin A deficiency Zinc Low birth weight chemistry Child Preschool Dietary Supplements Immunology Zinc deficiency Drug Therapy Combination Female medicine.symptom Post-Exposure Prophylaxis business Research Article |
| Zdroj: | BMC Public Health, Vol 10, Iss 1, p 145 (2010) BMC Public Health |
| ISSN: | 1471-2458 |
| Popis: | Background The benefits of zinc or multiple micronutrient supplementations in African children are uncertain. African children may differ from other populations of children in developing countries because of differences in the prevalence of zinc deficiency, low birth weight and preterm delivery, recurrent or chronic infections such as HIV, or the quality of complementary diets and genetic polymorphisms affecting iron metabolism. The aim of this study was to ascertain whether adding zinc or multiple micronutrients to vitamin A supplementation improves longitudinal growth or reduces prevalence of anemia in children aged 6-24 months. Methods Randomized, controlled double-blinded trial of prophylactic micronutrient supplementation to children aged 6-24 months. Children in three cohorts - 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers, and 187 uninfected children born to HIV-uninfected mothers - were separately randomly assigned to receive daily vitamin A (VA) [n = 124], vitamin A plus zinc (VAZ) [n = 123], or multiple micronutrients that included vitamin A and zinc (MM) [n = 126]. Results Among all children there were no significant differences between intervention arms in length-for-age Z scores (LAZ) changes over 18 months. Among stunted children (LAZ below -2) [n = 62], those receiving MM had a 0.7 Z-score improvement in LAZ versus declines of 0.3 in VAZ and 0.2 in VA (P = 0.029 when comparing effects of treatment over time). In the 154 HIV-uninfected children, MM ameliorated the effect of repeated diarrhea on growth. Among those experiencing more than six episodes, those receiving MM had no decline in LAZ compared to 0.5 and 0.6 Z-score declines in children receiving VAZ and VA respectively (P = 0.06 for treatment by time interaction). After 12 months, there was 24% reduction in proportion of children with anemia (hemoglobin below 11 g/dL) in MM arm (P = 0.001), 11% in VAZ (P = 0.131) and 18% in VA (P = 0.019). Although the within arm changes were significant; the between-group differences were not significant. Conclusions Daily multiple micronutrient supplementation combined with vitamin A was beneficial in improving growth among children with stunting, compared to vitamin A alone or to vitamin A plus zinc. Effects on anemia require further study. Trial registration This study is registered with ClinicalTrials.gov, number .NCT00156832. |
| Databáze: | OpenAIRE |
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