Zinc and vitamin A supplementation in Australian Indigenous children with acute diarrhoea: a randomised controlled trial.
OBJECTIVE
To evaluate the role of zinc and vitamin A supplementation in the recovery of Indigenous children hospitalised for acute diarrhoea.


METHODS
A randomised controlled 2 by 2 factorial trial of supplementation with zinc and vitamin A.


METHODS
Aboriginal children (aged < 11 years) hospitalised for acute diarrhoea at Alice Springs Hospital, Northern Territory, April 2001-July 2002.


METHODS
Duration of diarrhoeal illness; re-admission for diarrhoeal illness within 120 days.


RESULTS
Our study involved 392 Aboriginal children with 436 episodes of diarrhoea. Supplementation with zinc, vitamin A, or combined zinc and vitamin A had no significant effect on duration of diarrhoea or rate of re-admission compared with placebo. Median diarrhoea duration after starting supplementation was 3.0 days for the vitamin A and zinc supplemented and placebo groups (P values 0.25 and 0.69, respectively). The number of re-admissions did not differ significantly between those receiving vitamin A or zinc and the relevant placebo groups (relative risk [95% CI], 1.2 [0.7-2.1] and 1.3 [0.8-2.1], respectively).


CONCLUSIONS
Vitamin A and zinc supplementation may not be indicated for in-hospital management of acute diarrhoeal disease in Aboriginal children living in remote areas. This finding may not apply to children with malnutrition, for whom other studies suggest a benefit. Larger trials incorporating more comprehensive data on the vitamin A and zinc status as well as nutritional status of study populations might help to explain the different results in different populations.
Valery
Patricia C
PC
Population Studies and Human Genetics, Queensland Institute of Medical Research, Herston, Australia. patriciV@qimr.edu.au
Torzillo
Paul J
PJ
Boyce
Naomi C
NC
White
Andrew V
AV
Stewart
Peter A
PA
Wheaton
Gavin R
GR
Purdie
David M
DM
Wakerman
John
J
Chang
Anne B
AB
D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015876:Northern Territory / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data; D011188:Potassium / Q000097:blood; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014801:Vitamin A / Q000008:administration & dosage / Q000627:therapeutic use*; D015032:Zinc / Q000008:administration & dosage / Q000627:therapeutic use*
D014801:Vitamin A; D015032:Zinc; D011188:Potassium