Effect of zinc supplementation on mortality in children aged 1-48 months: a community-based randomised placebo-controlled trial.
BACKGROUND
Studies from Asia have suggested that zinc supplementation can reduce morbidity and mortality in children, but evidence from malarious populations in Africa has been inconsistent. Our aim was to assess the effects of zinc supplementation on overall mortality in children in Pemba, Zanzibar.


METHODS
We enrolled 42,546 children aged 1-36 months, contributing a total of 56,507 child-years in a randomised, double-blind, placebo-controlled trial in Pemba, Zanzibar. Randomisation was by household. 21 274 children received daily supplementation with zinc 10 mg (5 mg in children younger than 12 months) for mean 484.7 days (SD 306.6). 21,272 received placebo. The primary endpoint was overall mortality, and analysis was by intention to treat. This study is registered as an International Standard Randomised Clinical Trial, number ISRCTN59549825.


RESULTS
Overall, there was a non-significant 7% (95% CI -6% to 19%; p=0.29) reduction in the relative risk of all-cause mortality associated with zinc supplementation.


CONCLUSIONS
We believe that a meta-analysis of all studies of mortality and morbidity, will help to make evidence-based recommendations for the role of zinc supplementation in public health policy to improve mortality, morbidity, growth, and development in young children.
Sazawal
Sunil
S
Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Black
Robert E
RE
Ramsan
Mahdi
M
Chwaya
Hababu M
HM
Dutta
Arup
A
Dhingra
Usha
U
Stoltzfus
Rebecca J
RJ
Othman
Mashavi K
MK
Kabole
Fatma M
FM
D017677:Age Distribution; D002423:Cause of Death; D046688:Child Mortality; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000379:methods*; D003141:Communicable Diseases / Q000401:mortality*; D003153:Community Health Services; D003968:Diarrhea, Infantile / Q000401:mortality / Q000517:prevention & control; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008288:Malaria / Q000401:mortality / Q000517:prevention & control; D008297:Male; D009032:Mosquito Control / Q000706:statistics & numerical data; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D015032:Zinc / Q000008:administration & dosage*
D015032:Zinc