title: Major reduction of malaria morbidity with combined vitamin A and zinc supplementation in young children in Burkina Faso: a randomized double blind trial.
abstract: BACKGROUND
  Vitamin A and zinc are crucial for normal immune function, and may play a synergistic role for reducing the risk of infection including malaria caused by Plasmodium falciparum.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled trial of a single dose of 200 000 IU of vitamin A with daily zinc supplementation was done in children of Sourkoudougou village, Burkina Faso. Children aged from 6 to 72 months were randomized to receive a single dose of 200 000 IU of vitamin A plus 10 mg elemental zinc, six days a week (n = 74) or placebo (n = 74) for a period of six months. Cross-sectional surveys were conducted at the beginning and the end of the study, and children were evaluated daily for fever. Microscopic examination of blood smear was done in the case of fever (temperature > or =37.5 degrees C) for malaria parasite detection.
  
  
  RESULTS
  At the end of the study we observed a significant decrease in the prevalence malaria in the supplemented group (34%) compared to the placebo group (3.5%) (p < 0.001). Malaria episodes were lower in the supplemented group (p = 0.029), with a 30.2% reduction of malaria cases (p = 0.025). Time to first malaria episode was longer in the supplemented group (p = 0.015). The supplemented group also had 22% fewer fever episodes than the placebo group (p = 0.030).
  
  
  CONCLUSIONS
  These results suggest that combined vitamin A plus zinc supplementation reduces the risk of fever and clinical malaria episodes among children, and thus may play a key role in malaria control strategies for children in Africa.
authors.affiliation: Institut de recherche en sciences de la santé (IRSS), Bobo Dioulasso, Burkina Faso. nawidzeb@yahoo.fr
authors.forename: Augustin N
authors.initials: AN
authors.lastname: Zeba
authors.forename: Hermann
authors.initials: H
authors.lastname: Sorgho
authors.forename: Noël
authors.initials: N
authors.lastname: Rouamba
authors.forename: Issiaka
authors.initials: I
authors.lastname: Zongo
authors.forename: Jeremie
authors.initials: J
authors.lastname: Rouamba
authors.forename: Robert T
authors.initials: RT
authors.lastname: Guiguemdé
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
authors.forename: Najat
authors.initials: N
authors.lastname: Mokhtar
authors.forename: Jean-Bosco
authors.initials: JB
authors.lastname: Ouedraogo
mesh_terms: D002050:Burkina Faso; D002675:Child, Preschool; D019587:Dietary Supplements; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D015995:Prevalence; D014131:Trace Elements / Q000627:therapeutic use; D016896:Treatment Outcome; D014801:Vitamin A / Q000627:therapeutic use*; D014802:Vitamin A Deficiency / Q000276:immunology*; D014815:Vitamins / Q000627:therapeutic use; D015032:Zinc / Q000172:deficiency* / Q000627:therapeutic use*
chemical_list: D014131:Trace Elements; D014815:Vitamins; D014801:Vitamin A; D015032:Zinc