CoChat
Sign Up
Cited by 312Child Nutrition and Water AccessTrace Elements in HealthGlobal Maternal and Child Health

Preventive zinc supplementation in developing countries: impact on mortality and morbidity due to diarrhea, pneumonia and malaria

Open access
Yakoob, Mohammad Yawar, Theodoratou, Evropi, Jabeen, Afshan, Imdad, Aamer, Eisele, Thomas P, Ferguson, Joy, Jhass, Arnoupe, Rudan, Igor +3 more·2011·BMC Public Health
DOI 10.1186/1471-2458-11-s3-s23PMC PMC3231897
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Zinc deficiency is commonly prevalent in children in developing countries and plays a role in decreased immunity and increased risk of infection. Preventive zinc supplementation in healthy children can reduce mortality due to common causes like diarrhea, pneumonia and malaria. The main objective was to determine all-cause mortality and cause-specific mortality and morbidity in children under five in developing countries for preventive zinc supplementation. Data sources/ review methods: A literature search was carried out on PubMed, the Cochrane Library and the WHO regional databases to identify RCTs on zinc supplementation for greater than 3 months in children less than 5 years of age in developing countries and its effect on mortality was analyzed. Results: The effect of preventive zinc supplementation on mortality was given in eight trials, while cause specific mortality data was given in five of these eight trials. Zinc supplementation alone was associated with a statistically insignificant 9% (RR = 0.91; 95% CI: 0.82, 1.01) reduction in all cause mortality in the intervention group as compared to controls using a random effect model. The impact on diarrhea-specific mortality of zinc alone was a non-significant 18% reduction (RR = 0.82; 95% CI: 0.64, 1.05) and 15% for pneumonia-specific mortality (RR = 0.85; 95% CI: 0.65, 1.11). The incidence of diarrhea showed a 13% reduction with preventive zinc supplementation (RR = 0.87; 95% CI: 0.81, 0.94) and a 19% reduction in pneumonia morbidity (RR = 0.81; 95% CI: 0.73, 0.90). Keeping in mind the direction of effect of zinc supplementation in reducing diarrhea and pneumonia related morbidity and mortality; we considered all the outcomes for selection of effectiveness estimate for inclusion in the LiST model. After application of the CHERG rules with consideration to quality of evidence and rule # 6, we used the most conservative estimates as a surrogate for mortality. We, therefore, conclude that zinc supplementation in children is associated with a reduction in diarrhea mortality of 13% and pneumonia mortality of 15% for inclusion in the LiST tool. Preventive zinc supplementation had no effect on malaria specific mortality (RR = 0.90; 95% CI: 0.77, 1.06) or incidence of malaria (RR=0.92; 95 % CI 0.82-1.04) Conclusion: Zinc supplementation results in reductions in diarrhea and pneumonia mortality.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/1471-2458-11-s3-s23

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. RevMan The Cochrane Colloboration. Review Manager (RevMan) 5 for Windows 2003 Oxford England

Cited by

Sorted by citations

Related

Authors
Yakoob, M. Y., Theodoratou, E., Jabeen, A., Imdad, A., Eisele, T. P., Ferguson, J., Jhass, A., Rudan, I., Campbell, H., Black, R. E., & Bhutta, Z. A.
Affiliations
  • Aga Khan University (PK)
  • Tulane University (US)
  • University of Edinburgh (GB)
  • Johns Hopkins University (US)
Corresponding author
Bhutta, Zulfiqar A
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2011-04-13
Volume
11
Issue
S3
Pages
S23-S23
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/1471-2458-11-s3-s23
PMC
PMC3231897
OpenAlex
W2128948174
Cited by
312
References
39
Citations by year
2026: 5 · 2025: 14 · 2024: 11 · 2023: 16 · 2022: 19 · 2021: 20 · 2020: 24 · 2019: 19 · 2018: 16 · 2017: 18 · 2016: 20 · 2015: 26 · 2014: 38 · 2013: 36 · 2012: 24
FWCI
3.97
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
  • eCommons - AKU (Aga Khan University) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Bill and Melinda Gates Foundation
  • UNICEF
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, zinc deficiency, children under five, diarrhea mortality, malaria mortality, all-cause mortality, developing countries, child mortality estimation, diarrhea incidence, pneumonia incidence, malaria incidence, infectious disease prevention, healthcare workers, health care financing
MeSH terms
Child, Developing Countries, Diarrhea, Humans, Malaria, Pneumonia, Trace Elements, Zinc Compounds, Dietary Supplements

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review