Effect of Zinc Supplementation in Children with Severe Pneumonia: A Randomised Controlled Study

摘要

Pneumonia is one of the leading cause of mortality among children under five years of age globally and responsible for 18 % of all deaths. Zinc is thought to help in decreasing the susceptibility to acute lower respiratory infections by regulating various immune functions.Aim: To evaluate the effect of zinc supplementation on clinical resolution, duration of hospital stay and recurrence in next three months in children with severe pneumonia.Materials and Methods: This was a randomised, double-blind, placebo-controlled trial done in the Department of Paediatrics of a tertiary care hospital, where in a total of 560 children, aged 2-60 months, admitted with the diagnosis of severe pneumonia {according to WHO case definition i.e., fever, cough, fast breathing (respiratory rate =50/minute in 2-12 month and =40/minute in 1-5 years of age) and lower chest indrawing}, between November 2013 to October 2015, were included in this study. Subjects were randomised blindly into zinc and placebo group in 1:1 ratio. Zinc or placebo supplementation was given (10 mg in 2-6 months and 20 mg in 7-60 months of age) orally daily once for two weeks, to each child according to randomisation. Outcome measures were calculation of time taken for clinical resolution of pneumonia, duration of hospital stay in completed days and counting the number of episodes of pneumonia in the next three months from the date of admission. Statistical analysis was done using Microsoft Excel 2007. Outcome measures were compared between zinc and placebo group by calculating p-value (p-value <0.05 was taken as significant), odds ratio and 95% confidence interval. Other variables were analysed by calculating mean, standard deviation and p-value.Results: When compared among zinc group and placebo group, zinc group showed significant acceleration in clinical resolution of pneumonia (p=0.042) and reduction in the duration of hospital stay (p=0.035). However, zinc supplementation and recurrence of pneumonia showed no significant association (p=0.52).Conclusion: Zinc supplementation can be considered in the treatment of severe pneumonia in children to accelerate the clinical resolution and thereby to reduce the hospital stay. However, zinc supplementation has no role in the prevention of pneumonia in next three months.