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Effect of zinc supplementation on mortality in children aged 1–48 months: a community-based randomised placebo-controlled trial
Abstract
Background Studies from Asia have suggested that zinc supplementation can reduce morbidity and mortality in children, but evidence from malarious populations in Africa has been inconsistent. Our aim was to assess the effects of zinc supplementation on overall mortality in children in Pemba, Zanzibar.Methods We enrolled 42,546 children aged 1-36 months, contributing a total of 56,507 child-years in a randomised, double-blind, placebo-controlled trial in Pemba, Zanzibar. Randomisation was by household. 21 274 children received daily supplementation with zinc 10 mg (5 mg in children younger than 12 months) for mean 484.7 days (SD 306.6). 21,272 received placebo. The primary endpoint was overall mortality, and analysis was by intention to treat. This study is registered as an International Standard Randomised Clinical Trial, number ISRCTN59549825.Findings Overall, there was a non-significant 7% (95% CI -6% to 19%; p=0.29) reduction in the relative risk of all-cause mortality associated with zinc supplementation.Interpretation We believe that a meta-analysis of all studies of mortality and morbidity, will help to make evidence-based recommendations for the role of zinc supplementation in public health policy to improve mortality, morbidity, growth, and development in young children.
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“Re-Analysis of the same trials for disease-specific outcomes, which is necessary to extrapo late effects to populations with different causes of death, reduced their statistical power and gave 95% CIs that spanned 1·0.”
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“randomised trials of zinc supplementation were designed to detect effects on total mortality.36,153”
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Metadata
- Authors
- Sazawal, S., Black, R. E., Ramsan, M., Chwaya, H. M., Dutta, A., Dhingra, U., Stoltzfus, R. J., Othman, M. K., & Kabole, F. M.
- Affiliations
- Johns Hopkins University (US)
- Public Health Laboratory Ivo de Carneri (TZ)
- United Nations Children's Fund (US)
- Cornell University (US)
- Corresponding author
- Black, Robert E
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2007-03
- Volume
- 369
- Issue
- 9565
- Pages
- 927-934
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2146384937
- Cited by
- 138
- References
- 49
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 1 · 2021: 6 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 6 · 2016: 5 · 2015: 5 · 2014: 9 · 2013: 9 · 2012: 11
- FWCI
- 17.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Funders
- United States Agency for International Development
- Bill and Melinda Gates Foundation
- United Nations Foundation
- Johns Hopkins Bloomberg School of Public Health
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- zinc supplementation, child mortality, infant and young child nutrition, micronutrient supplementation, all-cause mortality, community-based trial
- MeSH terms
- Cause of Death, Child, Preschool, Communicable Disease Control, Communicable Diseases, Community Health Services, Diarrhea, Infantile, Double-Blind Method, Female, Follow-Up Studies, Humans, Infant, Malaria, Male, Mosquito Control, Socioeconomic Factors, Tanzania, Zinc, Age Distribution, Sex Distribution, Dietary Supplements, Child Mortality
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