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The influence of zinc supplementation on morbidity due to Plasmodium falciparum: a randomized trial in preschool children in Papua New Guinea.
A H Shankar
A H Shankar
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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B Genton
B Genton
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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M Baisor
M Baisor
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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J Paino
J Paino
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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S Tamja
S Tamja
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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T Adiguma
T Adiguma
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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L Wu
L Wu
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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L Rare
L Rare
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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D Bannon
D Bannon
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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J M Tielsch
J M Tielsch
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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K P West Jr
K P West Jr
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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M P Alpers
M P Alpers
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
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Zinc is crucial for normal immune function and can reduce morbidity from multiple infectious diseases. To determine the influence of zinc on malaria morbidity we conducted a randomized placebo-controlled trial of daily zinc supplementation in children residing in a malaria endemic region of Papua New Guinea. A total of 274 preschool children aged 6 to 60 months were given 10 mg elemental zinc (n = 136) or placebo (n = 138) for 6 days a week for 46 weeks. Slide-confirmed malaria episodes were detected by surveillance of cases self-reporting to a local health center. Cross-sectional surveys were conducted at the beginning, middle, and end of the study to assess infection rates, parasite density, spleen enlargement, and hemoglobin levels. Zinc supplementation resulted in a 38% (95% CI 3-60, P = 0.037) reduction in Plasmodium falciparum health center-based episodes, defined as parasitemia > or = 9200 parasites/microl with axial temperature > or = 37.5 degreesC or reported fever. Episodes accompanied by any parasitemia were also reduced by 38% (95% CI 5-60, P = 0.028), and episodes with parasitemia > or = 100,000/microl were reduced by 69% (95% CI 25-87, P = 0.009). There was no evidence of the effects of zinc on Plasmodium vivax morbidity or on health center attendance for causes other than P. falciparum. Zinc had no consistent effect on cross-sectional malariometric indices. Although P. falciparum prevalence tended to be lower at the end of the study in children given the placebo, such changes were absent at the mid-study survey. These results suggest that improved dietary zinc intake may reduce morbidity due to P. falciparum.
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| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 429 | 342 | 46 |
| Full Text Views | 748 | 7 | 0 |
| PDF Downloads | 246 | 8 | 0 |