Simultaneous zinc and vitamin A supplementation in Bangladeshi children: Randomised double blind controlled trial

M. M. Rahman, S. H. Vermund, M. A. Wahed, G. J. Fuchs, Abdullah Baqui, J. O. Alvarez

Research output: Contribution to journalArticle

Abstract

Objective To evaluate the effect of simultaneous zinc and vitamin A supplementation on diarrhoea and acute lower respiratory infections in children. Study design Randomised double blind placebo controlled trial. Setting Urban slums of Dhaka, Bangladesh. Participants and methods 800 children aged 12-35 months were randomly assigned to one of four intervention groups: 20 mg zinc once daily for 14 days; 200 000 IU vitamin A, single dose on day 14; both zinc and vitamin A; placebo. The children were followed up once a week for six months, and morbidity information was collected. Results The incidence and prevalence of diarrhoea were lower in the zinc and vitamin A groups than in the placebo group. Zinc and vitamin A interaction had a rate ratio (95% confidence interval) of 0.79 (0.66 to 0.94) for the prevalence of persistent diarrhoea and 0.80 (0.67 to 0.95) for dysentery. Incidence (1.62; 1.16 to 2.25) and prevalence (2.07; 1.76 to 2.44) of acute lower respiratory infection were significantly higher in the zinc group than in the placebo group. The interaction term had rate ratios of 0.75 (0.46 to 1.20) for incidence and 0.58 (0.46 to 0.73) for prevalence of acute lower respiratory infection. Conclusions Combined zinc and vitamin A synergistically reduced the prevalence of persistent diarrhoea and dysentery. Zinc was associated with a significant increase in acute lower respiratory infection, but this adverse effect was reduced by the interaction between zinc and vitamin A.

Original languageEnglish (US)
Pages (from-to)314-318
Number of pages5
JournalBMJ (Online)
Volume323
Issue number7308
StatePublished - Aug 11 2001
Externally publishedYes

Fingerprint

Vitamin A
Zinc
Respiratory Tract Infections
Diarrhea
Placebos
Dysentery
Incidence
Poverty Areas
Bangladesh
Confidence Intervals
Morbidity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Rahman, M. M., Vermund, S. H., Wahed, M. A., Fuchs, G. J., Baqui, A., & Alvarez, J. O. (2001). Simultaneous zinc and vitamin A supplementation in Bangladeshi children: Randomised double blind controlled trial. BMJ (Online), 323(7308), 314-318.

Simultaneous zinc and vitamin A supplementation in Bangladeshi children : Randomised double blind controlled trial. / Rahman, M. M.; Vermund, S. H.; Wahed, M. A.; Fuchs, G. J.; Baqui, Abdullah; Alvarez, J. O.

In: BMJ (Online), Vol. 323, No. 7308, 11.08.2001, p. 314-318.

Research output: Contribution to journalArticle

Rahman, MM, Vermund, SH, Wahed, MA, Fuchs, GJ, Baqui, A & Alvarez, JO 2001, 'Simultaneous zinc and vitamin A supplementation in Bangladeshi children: Randomised double blind controlled trial', BMJ (Online), vol. 323, no. 7308, pp. 314-318.
Rahman, M. M. ; Vermund, S. H. ; Wahed, M. A. ; Fuchs, G. J. ; Baqui, Abdullah ; Alvarez, J. O. / Simultaneous zinc and vitamin A supplementation in Bangladeshi children : Randomised double blind controlled trial. In: BMJ (Online). 2001 ; Vol. 323, No. 7308. pp. 314-318.
@article{515257a1d3cb418d985d85efd1af7eca,
title = "Simultaneous zinc and vitamin A supplementation in Bangladeshi children: Randomised double blind controlled trial",
abstract = "Objective To evaluate the effect of simultaneous zinc and vitamin A supplementation on diarrhoea and acute lower respiratory infections in children. Study design Randomised double blind placebo controlled trial. Setting Urban slums of Dhaka, Bangladesh. Participants and methods 800 children aged 12-35 months were randomly assigned to one of four intervention groups: 20 mg zinc once daily for 14 days; 200 000 IU vitamin A, single dose on day 14; both zinc and vitamin A; placebo. The children were followed up once a week for six months, and morbidity information was collected. Results The incidence and prevalence of diarrhoea were lower in the zinc and vitamin A groups than in the placebo group. Zinc and vitamin A interaction had a rate ratio (95{\%} confidence interval) of 0.79 (0.66 to 0.94) for the prevalence of persistent diarrhoea and 0.80 (0.67 to 0.95) for dysentery. Incidence (1.62; 1.16 to 2.25) and prevalence (2.07; 1.76 to 2.44) of acute lower respiratory infection were significantly higher in the zinc group than in the placebo group. The interaction term had rate ratios of 0.75 (0.46 to 1.20) for incidence and 0.58 (0.46 to 0.73) for prevalence of acute lower respiratory infection. Conclusions Combined zinc and vitamin A synergistically reduced the prevalence of persistent diarrhoea and dysentery. Zinc was associated with a significant increase in acute lower respiratory infection, but this adverse effect was reduced by the interaction between zinc and vitamin A.",
author = "Rahman, {M. M.} and Vermund, {S. H.} and Wahed, {M. A.} and Fuchs, {G. J.} and Abdullah Baqui and Alvarez, {J. O.}",
year = "2001",
month = "8",
day = "11",
language = "English (US)",
volume = "323",
pages = "314--318",
journal = "British Medical Journal",
issn = "0959-8146",
publisher = "BMJ Publishing Group",
number = "7308",

}

TY - JOUR

T1 - Simultaneous zinc and vitamin A supplementation in Bangladeshi children

T2 - Randomised double blind controlled trial

AU - Rahman, M. M.

AU - Vermund, S. H.

AU - Wahed, M. A.

AU - Fuchs, G. J.

AU - Baqui, Abdullah

AU - Alvarez, J. O.

PY - 2001/8/11

Y1 - 2001/8/11

N2 - Objective To evaluate the effect of simultaneous zinc and vitamin A supplementation on diarrhoea and acute lower respiratory infections in children. Study design Randomised double blind placebo controlled trial. Setting Urban slums of Dhaka, Bangladesh. Participants and methods 800 children aged 12-35 months were randomly assigned to one of four intervention groups: 20 mg zinc once daily for 14 days; 200 000 IU vitamin A, single dose on day 14; both zinc and vitamin A; placebo. The children were followed up once a week for six months, and morbidity information was collected. Results The incidence and prevalence of diarrhoea were lower in the zinc and vitamin A groups than in the placebo group. Zinc and vitamin A interaction had a rate ratio (95% confidence interval) of 0.79 (0.66 to 0.94) for the prevalence of persistent diarrhoea and 0.80 (0.67 to 0.95) for dysentery. Incidence (1.62; 1.16 to 2.25) and prevalence (2.07; 1.76 to 2.44) of acute lower respiratory infection were significantly higher in the zinc group than in the placebo group. The interaction term had rate ratios of 0.75 (0.46 to 1.20) for incidence and 0.58 (0.46 to 0.73) for prevalence of acute lower respiratory infection. Conclusions Combined zinc and vitamin A synergistically reduced the prevalence of persistent diarrhoea and dysentery. Zinc was associated with a significant increase in acute lower respiratory infection, but this adverse effect was reduced by the interaction between zinc and vitamin A.

AB - Objective To evaluate the effect of simultaneous zinc and vitamin A supplementation on diarrhoea and acute lower respiratory infections in children. Study design Randomised double blind placebo controlled trial. Setting Urban slums of Dhaka, Bangladesh. Participants and methods 800 children aged 12-35 months were randomly assigned to one of four intervention groups: 20 mg zinc once daily for 14 days; 200 000 IU vitamin A, single dose on day 14; both zinc and vitamin A; placebo. The children were followed up once a week for six months, and morbidity information was collected. Results The incidence and prevalence of diarrhoea were lower in the zinc and vitamin A groups than in the placebo group. Zinc and vitamin A interaction had a rate ratio (95% confidence interval) of 0.79 (0.66 to 0.94) for the prevalence of persistent diarrhoea and 0.80 (0.67 to 0.95) for dysentery. Incidence (1.62; 1.16 to 2.25) and prevalence (2.07; 1.76 to 2.44) of acute lower respiratory infection were significantly higher in the zinc group than in the placebo group. The interaction term had rate ratios of 0.75 (0.46 to 1.20) for incidence and 0.58 (0.46 to 0.73) for prevalence of acute lower respiratory infection. Conclusions Combined zinc and vitamin A synergistically reduced the prevalence of persistent diarrhoea and dysentery. Zinc was associated with a significant increase in acute lower respiratory infection, but this adverse effect was reduced by the interaction between zinc and vitamin A.

UR - http://www.scopus.com/inward/record.url?scp=0035845304&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035845304&partnerID=8YFLogxK

M3 - Article

C2 - 11498488

AN - SCOPUS:0035845304

VL - 323

SP - 314

EP - 318

JO - British Medical Journal

JF - British Medical Journal

SN - 0959-8146

IS - 7308

ER -