Khera Daisy, Singh Surjit, Purohit Purvi, Sharma Praveen, Singh Kuldeep
Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India.
Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India.
Turk Thorac J. 2020 Nov;21(6):371-376. doi: 10.5152/TurkThoracJ.2019.19020. Epub 2020 Nov 1.
Acute lower respiratory infections are an important cause of morbidity and mortality in developing countries. Recent randomized trials of zinc supplementation for the prevention of acute lower respiratory tract infections have revealed discrepant findings. The main aim of this study was to evaluate the prevalence of zinc deficiency and the effect of zinc supplementation on respiratory infections.
A single center, prospective open-label interventional single-arm pre-post study of the effect of oral zinc supplementation in zinc deficient children aged 6 months to 5 years was done. A total of 465 healthy children of age 6 months to 5 years were enrolled in the study for estimation of the prevalence of zinc deficiency. Children having zinc deficiency were recruited to study the efficacy and safety of oral administration of 20 mg zinc for two weeks during a 6-month follow-up period.
There were statistically significant differences between the zinc deficient and non-deficient groups according to modified Kuppuswamy categorization of family status and exclusive breast feeding. There was significant difference in the mid arm circumference between the zinc deficient and non-deficient groups (p<0.001). There was significant difference (p<0.001) in the number of episodes of acute upper respiratory infections (AURI), mean duration of AURI, and acute lower respiratory infections (ALRI) between the two groups. There was no significant difference in the ALRI episodes between the two groups. After zinc supplementation in zinc deficient children, there was significant decrease in the number of episodes and mean duration of AURI (p<0.001) and ALRI (p<0.001) within six months after supplementation as compared with the preceding six months before supplementation.
This study reveals that a short course of zinc supplementation may reduce the burden of AURI/ALRI among the zinc deficient children, but larger studies are needed.
急性下呼吸道感染是发展中国家发病和死亡的重要原因。最近关于补充锌预防急性下呼吸道感染的随机试验结果不一。本研究的主要目的是评估锌缺乏的患病率以及补充锌对呼吸道感染的影响。
对6个月至5岁锌缺乏儿童进行了一项单中心、前瞻性开放标签干预单臂前后对照研究，以评估口服补充锌的效果。共有465名6个月至5岁的健康儿童参与研究以估计锌缺乏的患病率。招募锌缺乏儿童，在6个月的随访期内研究口服20毫克锌两周的疗效和安全性。
根据家庭状况和纯母乳喂养的改良库普苏瓦米分类，锌缺乏组和非缺乏组之间存在统计学显著差异。锌缺乏组和非缺乏组的上臂中部周长存在显著差异（p<0.001）。两组之间急性上呼吸道感染（AURI）发作次数、AURI平均持续时间和急性下呼吸道感染（ALRI）存在显著差异（p<0.001）。两组之间的ALRI发作次数无显著差异。锌缺乏儿童补充锌后，与补充前的六个月相比，补充后六个月内AURI（p<0.001）和ALRI（p<0.00）的发作次数和平均持续时间均显著减少。
本研究表明，短期补充锌可能减轻锌缺乏儿童的AURI/ALRI负担，但需要更大规模的研究。
