School
School of Public Health
Document Type
Dissertation
Department (new version)
Public Health
Date of Award
1999
Degree Name by School
Doctor of Public Health (DrPH) School of Public Health
Abstract
This study evaluated whether combined zinc and vitamin A supplementation would improve the biochemical indexes of vitamin A nutriture, reduce morbidity, and enhance growth in a randomized, double-blind, placebo-controlled intervention trial. Eight hundred children aged 12–35 months were randomly assigned to one of the four intervention groups: (1) zinc, (2) vitamin A, (3) zinc and vitamin A (zinc plus vitamin A), or (4) placebo. The zinc group received 20 mg of elemental zinc as syrup once daily for 14 days. The vitamin A group received a 200,000 IU (60 mg) vitamin A capsule on Day 14. The placebo group received both placebo syrup and placebo capsule. Blood was drawn at enrollment, on Day 21, and again at 3 months to test serum zinc, retinol, retinol binding protein (RBP), and C-reactive protein. Children were followed up at home once a week for 6 months and morbidity information was collected. Weight was measured once a month; length was measured upon enrollment and again after 3 and 6 months. Biochemical indexes were analyzed in 411 children; 103 in the zinc group, 104 in the vitamin A group, 103 in the zinc-vitamin A group, and 101 in the placebo group. Mean ± SD serum retinol was not different between the vitamin A and zinc plus vitamin A groups. Among the children who were initially vitamin A deficient, improvement of vitamin A status was significantly better in the zinc plus vitamin A group ( p < 0.05, compared with placebo). The proportions of children who remained vitamin A deficient (serum retinol <20 μg/d) after supplementation were 40.6% in the zinc group, 37.5% in the vitamin A group, and 47.0% in the placebo group, but only 13.3% in the zinc plus vitamin A group ( p < 0.05 compared with any other group). Also, the proportion of children who remained with low retinol binding protein was significantly lower in the zinc plus vitamin A group ( p < 0.05), as compared with any other group in the study. For morbidity, 666 children were studied. 170 in the zinc group, 160 in the vitamin A group, 175 in the zinc-vitamin A group, and 161 in the placebo group. Both the incidence and prevalence of diarrhea in the zinc, vitamin A, and zinc plus vitamin A groups were lower than in the placebo group. The prevention of diarrhea was more pronounced in the zinc plus vitamin A group. The prevalence of persistent diarrhea and bloody diarrhea (dysentery) was significantly lower in the combined zinc and vitamin A group as compared with any other group. The acute lower respiratory infection (ALRI) incidence and prevalence figures were significantly higher in the zinc group than those of the placebo. Weight and height gains during the 6-month follow-up period were not significantly different in the four groups. Catch-up growth also did not differ significantly between groups. The results of this study suggest a synergistic interaction between zinc and vitamin A that improved vitamin A status in deficient children and reduced diarrhea, particularly persistent diarrhea and dysentery. Conversely, zinc supplementation alone increased the incidence and prevalence of ALRI. This short-term supplementation did not have any effect on weight and height gains.
ProQuest Publication Number
ProQuest ID
9968167
ISBN
978-0-599-72911-7
Recommended Citation
Rahman, Mohammad Mujibur, "Effect of simultaneous zinc and vitamin A supplementation on the biochemical indices of vitamin A nutriture, morbidity, and growth in Bangladeshi children: A randomized, double blind, placebo controlled trial" (1999). All ETDs from UAB. 7204.
https://digitalcommons.library.uab.edu/etd-collection/7204
Comments
DrPH