Zinc and vitamin A supplementation in Indigenous Australian children hospitalised with lower respiratory tract infection: a randomised controlled trial.
OBJECTIVE
To evaluate the efficacy of supplementation with zinc and vitamin A in Indigenous children hospitalised with acute lower respiratory infection (ALRI).


METHODS
Randomised controlled, 2-by-2 factorial trial of supplementation with zinc and vitamin A.


METHODS
187 Indigenous children aged < 11 years hospitalised with 215 ALRI episodes at Alice Springs Hospital (April 2001 to July 2002).


METHODS
Vitamin A was administered on Days 1 and 5 of admission at a dose of 50 000 IU (infants under 12 months), or 100 000 IU; and zinc sulfate was administered daily for 5 days at a daily dose of 20 mg (infants under 12 months) or 40 mg.


METHODS
Time to clinical recovery from fever and tachypnoea, duration of hospitalisation, and readmission for ALRI within 120 days.


RESULTS
There was no clinical benefit of supplementation with vitamin A, zinc or the two combined, with no significant difference between zinc and no-zinc, vitamin A and no-vitamin A or zinc + vitamin A and placebo groups in time to resolution of fever or tachypnoea, or duration of hospitalisation. Instead, we found increased morbidity; children given zinc had increased risk of readmission for ALRI within 120 days (relative risk, 2.4; 95% CI, 1.003-6.1).


CONCLUSIONS
This study does not support the use of vitamin A or zinc supplementation in the management of ALRI requiring hospitalisation in Indigenous children living in remote areas. Even in populations with high rates of ALRI and poor living conditions, vitamin A and zinc therapy may not be useful. The effect of supplementation may depend on the prevalence of deficiency of these micronutrients in the population.
Chang
Anne B
AB
Department of Respiratory Medicine, Royal Children's Hospital, Herston Road, Herston, Brisbane, QLD 4029, Australia. annechang@ausdoctors.net
Torzillo
Paul J
PJ
Boyce
Naomi C
NC
White
Andrew V
AV
Stewart
Peter M
PM
Wheaton
Gavin R
GR
Purdie
David M
DM
Wakerman
John
J
Valery
Patricia C
PC
D002648:Child; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D014131:Trace Elements / Q000627:therapeutic use*; D014801:Vitamin A / Q000627:therapeutic use*; D014815:Vitamins / Q000627:therapeutic use*; D015032:Zinc / Q000627:therapeutic use*
D014131:Trace Elements; D014815:Vitamins; D014801:Vitamin A; D015032:Zinc