Zinc supplementation as adjunct therapy in children with measles accompanied by pneumonia: a double-blind, randomized controlled trial.
BACKGROUND
Zinc deficiency, common in developing countries, is associated with decreased immunocompetence. Zinc supplementation benefits children with acute and persistent diarrhea and prevents pneumonia. Most deaths from vaccine-preventable diseases are from measles and whooping cough; pneumonia is the most common complication of measles and often the proximate cause of related deaths.


OBJECTIVE
We evaluated the effect of zinc supplementation on episodes of illness in children with measles accompanied by pneumonia.


METHODS
In a double-blind, randomized controlled trial, children aged 9 mo-15 y who were admitted to the Infectious Diseases Hospital in Calcutta with clinically severe measles accompanied by pneumonia and who had been ill for </= 7 d were randomly assigned to receive zinc (20 mg, in elemental form as acetate, twice daily for 6 d) or a placebo. All patients received standard treatment with antibiotics and an initial 100 000-IU dose of vitamin A (as palmitate) by mouth.


RESULTS
Time-to-event analysis using the Cox proportional hazards model (42 in the zinc group and 43 in the placebo group) showed that the time needed for the resolution of fever and tachypnea, the return of appetite, and the achievement of a "much improved" or "cured" status was not different between the 2 groups. A high proportion of children had low serum retinol and zinc concentrations. Improvement in serum zinc and retinol concentrations after 6 d of treatment was not different between the 2 groups.


CONCLUSIONS
Children with severe measles accompanied by pneumonia treated with antibiotics and vitamin A did not show any additional benefit from also receiving a zinc supplement.
Society for Applied Studies, Calcutta, India. dmahalanabis@vsnl.com
Dilip
D
Mahalanabis
A
A
Chowdhury
S
S
Jana
Mihir K
MK
Bhattacharya
M K
MK
Chakrabarti
Mohammed A
MA
Wahed
Mohammad A
MA
Khaled
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001066:Appetite; D002648:Child; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005334:Fever; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000150:complications* / Q000188:drug therapy*; D010919:Placebos; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy*; D013054:Spectrophotometry, Atomic; D016896:Treatment Outcome; D014801:Vitamin A / Q000097:blood; D015032:Zinc / Q000008:administration & dosage* / Q000097:blood
D000900:Anti-Bacterial Agents; D010919:Placebos; D014801:Vitamin A; D015032:Zinc