The influence of zinc supplementation on morbidity due to Plasmodium falciparum: a randomized trial in preschool children in Papua New Guinea.

Abstract

Abstract. Zinc is crucial for normal immune function and can reduce morbidity from multiple infectious diseases. To determine the influence of zinc on malaria morbidity we conducted a randomized placebo-controlled trial of daily zinc supplementation in children residing in a malaria endemic region of Papua New Guinea. A total of 274 preschool children aged 6 to 60 months were given 10 mg elemental zinc (n ϭ 136) or placebo (n ϭ 138) for 6 days a week for 46 weeks. Slide-confirmed malaria episodes were detected by surveillance of cases self-reporting to a local health center. Cross-sectional surveys were conducted at the beginning, middle, and end of the study to assess infection rates, parasite density, spleen enlargement, and hemoglobin levels. Zinc supplementation resulted in a 38% (95% CI 3-60, P ϭ 0.037) reduction in Plasmodium falciparum health center-based episodes, defined as parasitemia Ն 9200 parasites/l with axial temperature Ն 37.5ЊC or reported fever. Episodes accompanied by any parasitemia were also reduced by 38% (95% CI 5-60, P ϭ 0.028), and episodes with parasitemia Ն 100,000/l were reduced by 69% (95% CI 25-87, P ϭ 0.009). There was no evidence of the effects of zinc on Plasmodium vivax morbidity or on health center attendance for causes other than P. falciparum. Zinc had no consistent effect on cross-sectional malariometric indices. Although P. falciparum prevalence tended to be lower at the end of the study in children given the placebo, such changes were absent at the mid-study survey. These results suggest that improved dietary zinc intake may reduce morbidity due to P. falciparum.

Lipid Peroxidation In Cerebral Malaria And Role Of Antioxidants

“…Also there is decrease in the level of plasma Vitamin E 20 and vitamin A 4 during malaria infection. Beneficial protective effects of retinol or zinc on malaria-related morbidity have been documented in Papua New Guinea, Peru and Zanzabari 23,24,25 .In our study there is gradual increase in serum MDA level as the parasitemia increases. Recently D'douza et al 2009 also found the increment in the serum MDA level 26 .…”

Antioxidant status and acute malaria in children in Kampala, Uganda.

“…16 Host nutritional status has generally been considered to be unrelated to the morbidity and mortality of malaria, 22 but new studies are challenging this belief. Community-based trials show that periodic high dose vitamin A supplementation 4 and oral zinc supplementation 23 reduce the morbidity due to P. falciparum malaria in Papua New Guinea. It is not known whether improved carotenoid status, either through dietary intervention or supplementation, will improve clinical outcomes of acute malaria.…”

Ratio of low serum zinc levels in elderly Japanese people living in the central part of Japan

“…Zinc deficiency is a serious problem in developing countries. Many studies have shown the adverse effects on growth and morbidity as well as the prevention of infection by zinc supplementation in pregnant women, infants and children (Bates et al, 1993;Goldenberg et al, 1995;Brown et al, 1998;Bhutta et al, 1999;Caulfield et al, 1999;Shankar et al, 2000;Osendarp et al, 2001;Black et al, 2004). Zinc deficiency has also been reported in industrialized countries.…”