Role of zinc supplementation in acute respiratory tract infections in children aged 2 to 60 months

Abstract

INTRODUCTIONAcute respiratory tract infections (ARI) are the most common illnesses in childhood. ARI comprises of as much as 50% of all illnesses in children less than 5 years old. It also comprises of 30% of all illnesses in children aged 5-12 years. There are many factors like infecting agents, environmental factors and host factors which determine the type of respiratory tract illnesses and their frequency.Amongst the host factors, improvement in nutrition has been considered to be the most important factor contributing to decrease in mortality and morbidity due to ARIs in children of developing countries.1 Recently, amongst all the nutrients, zinc deficiency has gained a lot of attention. Zinc deficiency is associated with impaired ABSTRACT Background: Zinc has a major role in improving immune function and decreasing morbidity in various infectious diseases like acute respiratory tract infections, diarrhoeal diseases etc. The objective of the study was to study the effect of zinc supplementation on clinical manifestations, progress of illness and duration of acute respiratory infections. Methods: A randomized double blind controlled study was conducted in the Paediatric ward of a tertiary care hospital in New Delhi in 50 children aged 2 to 60 months. Children with previous episodes of wheezing, severe malnutrition, congenital heart diseases, pneumonia, history of taking multiple micronutrient formulations or zinc for any intercurrent illnesses like diarrhoea in the previous month prior to admission and history of any known immunodeficiency disease or on any immunosuppressive medications(steroids) or anti malignancy treatment were excluded. Both placebo (syrup base) and zinc syrup (20 mg/5 mL elemental zinc as zinc sulfate) were given orally for a period of 14 days to the respective groups. Statistical analysis used: Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.). Chi-square test was done for qualitative variables and t-test was used for quantitative variables. P<0.05 was considered as statistically significant. Results: The mean age of zinc group was 22.77 months ) and that of placebo group was 22.86 months (SD -5.88) with a p value of 0.98 which was not statistically significant. There were no significant differences in the clinical features in the two groups before starting therapy or after treatment at 24, 48 and 72 hours (P>0.05). Conclusions: Zinc supplementation during episode of ARI did not show any substantial benefit in reducing duration or morbidity in children aged 2-60 months.

Comparing the effect of zinc gluconate and placebo in the treatment of tachypnea, dyspnea and fever in children aged 2 to 23 months with acute bronchiolitis

“…16 In a study in India at 2017 by Nayir et al, they investigated the effect of zinc in the treatment of acute respiratory infections in children aged 2 to 60 months and their study provided a significant advantage for zinc supplementation during the episode of acute respiratory infections did not show a decrease in the duration or complications of the disease. 17 But contrary to above studies and consistent with our findings a 2004 study by Brooks et al in Bangladesh showed that zinc supplementation in infants with severe pneumonia had a significant effect on decreasing the duration of breast compression, Tachypnea, has hypoxia thereby significantly reducing the duration of illness and length of stay. 10 A study by Valavi et al in Ahwaz in 2012 showed that the duration of fever and respiratory distress were significantly shorter in infants treated with zinc compared to placebo and patients required significantly shorter hospitalizations than controls.…”

Investigation of zinc levels in the blood of children between the ages of six months to five years old with acute respiratory tract infections

“…Prolonged hospital stay was associated with a reduction in mean serum zinc levels. The average zinc concentration decreased within the range of normal zinc levels in children who were hospitalized for a duration of less than 7 days [20][21][22] . In 76% of cases and 19% of controls, zinc insufficiency was observed.…”

“…Atypical pneumonias can be caused by Mycoplasma pneumonia and Chlamydia pneumonia. Acute respiratory tract infections have an incidence of 21.7% to 40% in underdeveloped nations [1][2][3] . Between 30 and 60 million cases of moderate to severe ARI occur annually in India, out of an estimated 300 million cases.…”

Pengaruh Suplementasi Seng terhadap Kejadian Tonsilitis pada Balita

“…27 Penelitian yang dilakukan oleh Nair pada balita usia 2-60 bulan juga menunjukkan tidak ada perbedaan yang signifikan pada penurunan durasi dan frekuensi kejadian infeksi saluran pernafasan di bagian atas antara kelompok placebo dan kelompok yang diberikan suplementasi seng 10 dan 20mg selama 14 hari. 28 Penelitian yang dilakukan oleh Malik pada bayi 6-12 bulan menunjukkan tidak ada perbedaan yang signifikan pada penurunan frekuensi kejadian ISPA antara kelompok placebo dan kelompok yang diberi intervensi seng 20mg selama 14 hari, namun terdapat penurunan lama waktu kesakitan selama periode follow up. 29 Berdasarkan tabel 3 menunjukkan rerata frekuensi kejadian tonsilitis pada kelompok kontrol 0,26 ± 0,562 dan kelompok intervensi 0,21 ± 0,419 yang berarti terdapat kecenderungan lebih rendah pada kelompok intervensi, namun belum signifikan secara statistik.…”