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Zinc supplementation for the prevention of pneumonia in children aged 2 months to 59 months

  1. Zohra S Lassi1,
  2. Batool A Haider2,
  3. Zulfiqar A Bhutta1,*

Editorial Group: Cochrane Acute Respiratory Infections Group

Published Online: 8 DEC 2010

Assessed as up-to-date: 26 JAN 2010

DOI: 10.1002/14651858.CD005978.pub2


How to Cite

Lassi ZS, Haider BA, Bhutta ZA. Zinc supplementation for the prevention of pneumonia in children aged 2 months to 59 months. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD005978. DOI: 10.1002/14651858.CD005978.pub2.

Author Information

  1. 1

    Aga Khan University Hospital, Division of Women and Child Health, Karachi, Pakistan

  2. 2

    Harvard School of Public Health, Departments of Epidemiology and Nutrition, Boston, MA, USA

*Zulfiqar A Bhutta, Division of Women and Child Health, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan. zulfiqar.bhutta@aku.edu.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 8 DEC 2010

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Bhandari 2002a {published data only}
  • Bhandari N, Bahl R, Taneja S, Strand T, Mølbak K, Ulvik RJ, et al. Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum. BMJ 2002;324:1358.
Bhandari 2002b {published data only}
  • Bhandari N, Bahl R, Taneja S, Strand T, Mølbak K, Ulvik RJ, et al. Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum. BMJ 2002;324:1358.
Bobat 2005 {published data only}
  • Bobat R, Coovadia H, Stephen C, Naidoo KL, McKerrow N, Black RE, et al. Safety and efficacy of zinc supplementation for children with HIV-1 infection in South Africa: a randomised double-blind placebo-controlled trial. Lancet 2005;26(366 (9500)):1862-7.
Brooks 2005 {published data only}
  • Brooks WA, Santosham M, Naheed A, Goswami D, Wahed MA, Diener-West M, et al. Effect of weekly zinc supplements on incidence of pneumonia and diarrhoea in children younger than 2 years in an urban, low-income population in Bangladesh: randomised controlled trial. Lancet 2005;366:999-1004.
Luabeya 2007 {published data only}
  • Luabeya KK, Mpontshane N, Mackay M, Ward H, Elson I, Chhagan M, et al. Zinc or multiple micronutrient supplementation to reduce diarrhoea and respiratory disease in South African children: a randomised controlled trial. PLoS ONE 2007;2(6):e541.
Penny 2004 {published data only}
  • Duggan C, Penny ME, Hibberd P, Gil A, Huapaya A, Cooper A, et al. Oligofructose-supplemented infant cereal: two randomised, blinded, community-based trials in Peruvian infants. American Journal of Clinical Nutrition 2003;77:937-42.
  • Penny ME, Marin RM, Duran A, Peerson JM, Lanata CF, Lönnerdal B, et al. Randomised community based trial of the effect of zinc supplementation, with and without other micronutrients, on the duration of persistent childhood diarrhoea in Lima, Peru. Journal of Pediatrics 135;135(2):208-17.
  • Penny ME, Marin RM, Duran A, Peerson JM, Lanata CF, Lönnerdal B, et al. Randomized controlled trial of the effect of daily supplementation with zinc or multiple micronutrients on the morbidity, growth, and micronutrient status of young Peruvian children. American Journal of Clinical Nutrition 2004;79(3):457-65.
Sazawal 1998a {published data only}
  • Sazawal S, Black RE, Bhan MK, Bhandari N, Sinha A, Jalla S. Zinc supplementation in young children with acute diarrhoea in India. New England Journal of Medicine 1995;333:839-44.
  • Sazawal S, Black RE, Bhan MK, Jalla S, Bhandari N, Sinha A, et al. Zinc supplementation reduces the incidence of persistent diarrhoea and dysentery among low socioeconomic children in India. Journal of Nutrition 1996;126:443-50.
  • Sazawal S, Black RE, Jalla S, Mazumdar S, Sinha A, Bhan MK. Zinc supplementation reduces the incidence of acute lower respiratory infections in infant and preschool children: a double-blind controlled trial. Pediatrics 1998;102:1-5.
Sazawal 1998b {published data only}
  • Sazawal S, Black RE, Jalla S, Mazumdar S, Sinha A, Bhan MK. Zinc supplementation reduces the incidence of acute lower respiratory infections in infant and preschool children: a double-blind controlled trial. Pediatrics 1998;102:1-5.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Baqui 2002 {published data only}
  • Baqui AH, Black RE, El Arifeen S, Yunus M, Chakraborty J, Ahmed S, et al. Effect of zinc supplementation started during diarrhoea on morbidity and mortality in Bangladeshi children: community randomised trial. BMJ 2002;325:1059.
Baqui 2003 {published data only}
  • Baqui AH, Zaman K, Persson LA, El Arifeen S, Yunus M, Begum N, et al. Simultaneous weekly supplementation of iron and zinc is associated with lower morbidity due to diarrhoea and acute lower respiratory infection in Bangladeshi infants. Journal of Nutrition 2003;133:4150–7.
Bates 1993 {published data only}
  • Bates CJ, Evans PH, Dardenne M, Prentice A, Lunn PG, Northrop-Clewes CA, et al. A trial of zinc supplementation in young rural Gambian children. British Journal of Nutrition 1993;69:243–55.
Castillo-Duran 1987 {published data only}
  • Castillo-Duran C, Heresi G, Fisberg M, Uauy R. Controlled trial of zinc supplementation during recovery from malnutrition:effects on growth and immune function. American Journal of Clinical Nutrition 1987;45:602–8.
Lind 2004 {published data only}
  • Lind T, Lonnerdal B, Stenlund H, Gamayanti IL, Ismail D, Seswandhana R, et al. A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: effects on growth and development. American Journal of Clinical Nutrition 2004;80:729–36.
Lira 1998 {published data only}
  • Lira PIC, Ashworth A, Morris SS. Effect of zinc supplementation on the morbidity, immune function, and growth of low-birth-weight, full-term infants in northeast Brazil. American Journal of Clinical Nutrition 1998;68:418-24.
Long 2006 {published data only}
  • Long KZ, Montoya Y, Hertzmark E, Santos JI, Rosado JL. A double-blind, randomized, clinical trial of the effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections in children in Mexico City, Mexico. American Journal of Clinical Nutrition 2006;83:693–700.
Ninh 1996 {published data only}
  • Ninh NX, Thissen JP, Collette L, Gerard G, Khoi HH, Ketelslegers JM. Zinc supplementation increases growth and circulating insulin-like growth factor I (IGF-I) in growth-retarded Vietnamese children. American Journal of Clinical Nutrition 1996;63:514–9.
Osendarp 2002 {published data only}
  • Osendarp SJM, Santosham M, Black RE, Wahed MA, Van Raaij MA, Fuchs GJ. Effect of zinc supplementation between 1 and 6 months of life on growth and morbidity of Bangladeshi infants in urban slums. American Journal of Clinical Nutrition 2002;76:1401-8.
Rahman 2001 {published data only}
  • Rahman MM, Vermund SH, Wahed MA, Fuchs GJ, Baqui AH, Alvarez JO. Simultaneous zinc and vitamin A supplementation in Bangladeshi children: randomised double blind controlled trial. BMJ 2001;323:314-8.
Reul 1997 {published data only}
  • Ruel MT, Rivera JA, Santizo MC, Lonnerdal B, Brown KH. Impact of zinc supplementation on morbidity from diarrhoea and respiratory infections among rural Guatemalan children. Pediatrics 1997;99:808–13.
Richard 2006 {published data only}
  • Richard SA, Zavaleta N, Caulfield LE, Black RE, Witzig RS, Shankar AH. Zinc and iron supplementation and malaria, diarrhoea, and respiratory infections in children in the Peruvian Amazon. American Journal of Tropical Medicine and Hygiene 2006;75:126–32.
Rosado 1997 {published data only}
  • Rosado JL, Lopez P, Munoz E, Martinez H, Allen LH. Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers. American Journal of Clinical Nutrition 1997;65:13–9.
Roy 1999 {published data only}
  • Roy SK, Tomkins AM, Haider R, Behren RH, Akramuzzaman SM, Mahalanabis D, et al. Impact of zinc supplementation on subsequent growth and morbidity in Bangladeshi children with acute diarrhoea. European Journal of Clinical Nutrition 1999;53:529–34.
Sempértegui 1996 {published data only}
  • Sempértegui F, Estrella B, Correa E, Aguirre L, Saa B, Torres M, et al. Effects of short-term zinc supplementation on cellular immunity, respiratory symptoms,and growth of malnourished Equadorian children. European Journal of Clinical Nutrition 1996;50:42–6.
Sur 2003 {published data only}
  • Sur D, Gupta DN, Mondal SK, Ghosh S, Manna B, Rajendran K, et al. Impact of zinc supplementation on diarrhoeal morbidity and growth pattern of low birth weight infants in Kolkata, India: a randomised, double-blind, placebo-controlled, community-based study. Pediatrics 2003;112:1327-32.
Taneja 2009 {published data only}
  • Taneja S, Bhandari N, Rongsen-Chandola T, Mahalanabis D, Fontaine O, Bhan MK. Effectof zinc supplementation on morbidity and growth in hospital-born, low-birth-weight infants. American Journal of Clinical Nutrition 2009;90:385-91.
Tielsch 2007 {published data only}
  • Tielsch JM, Khatry SK, Stoltzfus RJ, Katz J, LeClerq SC, Adhikari R, et al. Effect of daily zinc supplementation on child mortality in southernNepal: a community-based, cluster randomised, placebo controlled trial. Lancet 2007;370:1230–9.
Umeta 2000 {published data only}

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Aggarwal 2007
Bahl 1998
  • Bahl R, Bhandari N, Hambidge KM, Bhan MK. Plasma zinc as a predictor of diarrhoeal & respiratory morbidity in children in an urban slum setting. American Journal of Clinical Nutrition 1998;68(Suppl):414-7.
Bhandari 1994
Bhutta 1999
  • Bhutta ZA, Black RE, Brown KN, Gardner JM, Gore S, Hidayat A, et al. Zinc Investigators Collaborative Group. Prevention of diarrhoea & pneumonia by zinc supplementation in children in developing countries: pooled analysis of randomised controlled trials. Journal of Paediatrics 1999;135:689-97.
Black 1998
  • Black RE. Therapeutic & preventive effects of zinc on serious childhood infectious diseases in developing countries. American Journal of Clinical Nutrition 1998;68(Suppl 2):476-9.
Boluyt 2008
  • Boluyt N, Tjosvold L, Lefebvre C, Klassen TP, Offringa M. Usefulness of systematic review search strategies in finding child health systematic reviews in MEDLINE. Archives of Pediatric and Adolescent Medicine 2008;162(2):111-6.
Bryce 2005
Fraker 1993
  • Fraker PG, King LE, Gravy BA. The immunopathology of zinc deficiency in humans and rodents: a possible role for programmed cell death. New York, NY: In: Klurfeld DM, editor. Nutrition and Immunology, 1993.
Hambidge 1999
Higgins 2008
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.0 [updated February 2008]. The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org . Chichester, UK: Wiley-Blackwell.
Ibs 2003
  • Ibs KH, Rink L. Zinc-altered immune function. Journal of Nutrition 2003;133(5 Suppl 1):1452-6.
Ploysangam 1997
Ravaglia 2000
  • Ravaglia G, Forti P, Maioli F, Bastagli L, Facchini A, Mariani E, et al. Effect of micronutrient status on natural killer cell immune function in healthy free-living subjects aged ≥90 y. American Journal of Clinical Nutrition 2000;71(2):590-8.
RDA 1989
  • Subcommittee on the tenth edition of the RDAs of the Food and Nutrition Board. Recommended Dietary Allowances. 10th Edition. Washington DC: National Academy Press, 1989.
RevMan 2008 [Computer program]
  • The Nordic Cochrane Centre: The Cochrane Collaboration. The Cochrane Collaboration. Review Manager (RevMan). Version 5.0. Copenhagen: The Nordic Cochrane Centre: The Cochrane Collaboration, 2008.
Roth 2010
  • Roth DE, Richard SA, Black RE. Zinc supplementation for the prevention of acute lower respiratory infection in children in developing countries: meta-analysis and meta-regression of randomized trials. International Journal of Epidemiology 2010;39:795-808.
Rudan 2008
Sanstead 1995
Shankar 1998
  • Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection. American Journal of Clinical Nutrition 1998;68(Suppl 2):447­63.
White 1986
  • White E. The effect of misclassification of disease status in follow-up studies: implications for selecting disease classification criteria. American Journal of Epidemiology 1986;124:816–25.
WHO 1990
  • World Health Organization. Acute respiratory infections in children: Case. Programme for the Control of Acute Respiratory Infections. World Health Organization. Geneva, 1990. [WHO/ARI/90.5]
World Bank 2008
  • World Bank. Geographic classifications and data reported for geographic regions are for low-income and middle-income economies as defined by the World Bank. http://www.icce2010.org/docs/developingCountries.pdf (Accessed June 27, 2010) 2008.
Zinc Group 2000
  • Zinc Investigators Collaborative Group. Therapeutic effects of oral zinc in acute and persistent diarrhoea in children in developing countries: pooled analysis of randomised controlled trials. American Journal of Clinical Nutrition 2000;72:1516-22.