Diarrhea, Malaria, Zinc Deficiency
Conditions
Keywords
zinc supplementation, diarrhea management, zinc deficiency, malaria
Brief summary
Zinc supplementation can either be provided in a lower daily dose to prevent zinc deficiency or in a higher dose for 10-14 days as part of the treatment of diarrhea. It is important to determine how best to integrate programs designed either to prevent zinc deficiency or to treat diarrhea. The overall objective of this project is to determine the most effective approach to prevent zinc deficiency and treat diarrhea, such that a single approach could provide the maximal beneficial impact on the health and nutritional status of young children and greatest simplicity of implementation.
Detailed description
This is a single-center cluster- and household-randomized, partially masked, community-based efficacy trial of zinc supplementation. The study sample consists of 5 study groups in one region, with 34 clusters randomly assigned to 3 types of intervention communities. Communities will be randomly assigned to 1) early intervention communities, 2) later intervention communities, 3) non-intervention communities. Within each intervention cluster, children will be randomly assigned to the intervention group at the household level. Children aged 6-27 months at enrollment will be eligible. The study duration is 12 months. The investigators will assess the relative impact of daily preventive zinc supplementation (7 mg zinc/d for one year), intermittent preventive supplementation (10 mg zinc/d for 10 days every three months for one year), and zinc treatment during episodes of diarrhea (20 mg zinc/d for 10 days beginning with each episode of diarrhea during one year). Outcomes that will be assessed include the incidence and duration of all episodes of diarrhea, the incidence of malaria, physical growth, and (in a sub-group) biochemical indicators of zinc, iron and vitamin A status.
Interventions
DIETARY_SUPPLEMENTDaily preventive Zn; placebo treatment
7 mg zinc / day and placebo supplement during diarrhea episodes
DIETARY_SUPPLEMENTTherapeutic Zn; daily placebo
20 mg zinc / day for 10 days during diarrhea episodes and daily placebo supplement
DIETARY_SUPPLEMENTIntermittent Zn; placebo treatment
10 mg zinc for 10 days every 3 months, placebo supplements daily for all other days during 12 months; placebo supplements during diarrhea episodes
OTHERSurveillance control group
Active weekly morbidity surveillance for 3 months. New surveillance control group will be randomly assigned to intervention groups every 3 months
Sponsors
Université Polytechnique de Bobo-Dioulasso
Helen Keller International
Thrasher Research Fund
Canadian International Development Agency
University of California, Davis
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
6 Months to 27 Months
Healthy volunteers
Yes
Inclusion criteria
* 6-27 months of age * Plan to remain in study area for 1 year
Exclusion criteria
* Evidence of congenital abnormalities and chronic infection * Severe anemia and severe acute malnutrition * Consumption of micronutrient supplementation including zinc
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in length and length-for-age Z-score | 12 months |
| Change in weight and weight-for-age | 12 months |
| Incidence of diarrhea and laboratory-confirmed malaria | 12 months |
| Change in plasma zinc concentration | 12 months |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of stunting, underweight, and wasting | 12 months |
| Change in hemoglobin and iron status | 12 months |
Countries
Burkina Faso
Outcome results
None listed