title: Effect of zinc added to a daily small-quantity lipid-based nutrient supplement on diarrhoea, malaria, fever and respiratory infections in young children in rural Burkina Faso: a cluster-randomised trial.
abstract: OBJECTIVE
  Preventive zinc supplementation in the form of tablets or syrup reduces the incidence of diarrhoea and acute lower respiratory tract infections (RTI), but its effect on malaria is inconsistent. When zinc is administered with other micronutrients or foods, its effect is also uncertain. We assessed the effects of different amounts and sources of zinc on the frequency of diarrhoea, malaria, fever and RTI in young children.
  This community-based, double-blind, placebo-controlled, cluster-randomised trial of 2435 children 9 months of age was carried out between April 2010 and July 2012 in rural southwestern Burkina Faso.
  
  
  METHODS
  Participants were randomly assigned at the concession level to receive daily 1 of 4 interventions for 9 months: (1) 20 g small-quantity lipid-based nutrient supplement (SQ-LNS) without zinc and placebo tablet, (2) 20 g SQ-LNS with 5 mg zinc and placebo tablet, (3) 20 g SQ-LNS with 10 mg zinc and placebo tablet or (4) 20 g SQ-LNS without zinc and 5 mg zinc tablet. Participants were visited weekly in their homes for morbidity surveillance for 9 months, and those with uncomplicated diarrhoea and malaria received treatment from the study field workers in the community.
  
  
  RESULTS
  Incidence and longitudinal prevalence of diarrhoea, malaria, fever, and lower and upper RTI by intervention group.
  
  
  RESULTS
  The incidence of diarrhoea, malaria and fever was 1.10 (±1.03 SD), 0.61 (±0.66 SD) and 1.49 (±1.12 SD) episodes per 100 child-days at risk, respectively, and did not differ by intervention group (p=0.589, p=0.856 and p=0.830, respectively). The longitudinal prevalence of acute lower RTI (0.1%; 95% IC 0.1-0.2%) and of upper RTI (7.8%; 95% IC 7.1-8.4%) did not differ among groups (p=0.234 and p=0.501, respectively).
  
  
  CONCLUSIONS
  Inclusion of 5 or 10 mg zinc in SQ-LNS and provision of 5 mg zinc dispersible tablet along with SQ-LNS had no impact on the incidence of diarrhoea, malaria and fever or the longitudinal prevalence of RTI compared with SQ-LNS without zinc in this population.
  
  
  BACKGROUND
  NCT00944281.
authors.affiliation: Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo-Dioulasso, Burkina Faso Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA.
authors.forename: Jérôme W
authors.initials: JW
authors.lastname: Somé
authors.affiliation: Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA.
authors.forename: Souheila
authors.initials: S
authors.lastname: Abbeddou
authors.affiliation: Departments of Individual, Family and Community Education, and Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yakes Jimenez
authors.affiliation: Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA.
authors.forename: Sonja Y
authors.initials: SY
authors.lastname: Hess
authors.affiliation: Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo-Dioulasso, Burkina Faso.
authors.forename: Zinéwendé P
authors.initials: ZP
authors.lastname: Ouédraogo
authors.affiliation: Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo-Dioulasso, Burkina Faso.
authors.forename: Rosemonde M
authors.initials: RM
authors.lastname: Guissou
authors.affiliation: Department of Agricultural and Resource Economics, University of California, Davis, California, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Vosti
authors.affiliation: Institut de Recherche en Sciences de la Santé/Direction Régionale de l'Ouest, Bobo-Dioulasso, Burkina Faso.
authors.forename: Jean-Bosco
authors.initials: JB
authors.lastname: Ouédraogo
authors.affiliation: Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, California, USA The Bill and Melinda Gates Foundation, Seattle, Washington, USA.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Brown
mesh_terms: D002050:Burkina Faso / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003967:Diarrhea / Q000178:diet therapy* / Q000517:prevention & control; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005334:Fever / Q000178:diet therapy* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008055:Lipids / Q000008:administration & dosage*; D008288:Malaria / Q000178:diet therapy* / Q000517:prevention & control; D008297:Male; D018977:Micronutrients / Q000172:deficiency*; D012141:Respiratory Tract Infections / Q000178:diet therapy* / Q000517:prevention & control; D012424:Rural Population; D016896:Treatment Outcome; D015032:Zinc / Q000008:administration & dosage*
chemical_list: D008055:Lipids; D018977:Micronutrients; D015032:Zinc
keywords: NUTRITION & DIETETICS