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Zinc and vitamin A supplementation in Australian Indigenous children with acute diarrhoea: a randomised controlled trial
Author(s) -
Valery Patricia C,
Purdie David M,
Torzillo Paul J,
Stewart Peter A,
Boyce Naomi C,
Chang Anne B,
White Andrew V,
Wheaton Gavin R,
Wakerman John
Publication year - 2005
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2005.tb00021.x
Subject(s) - medicine , placebo , vitamin , malnutrition , diarrhea , randomized controlled trial , diarrhoeal disease , pediatrics , vitamin a deficiency , indigenous , retinol , alternative medicine , pathology , ecology , biology
Objective: To evaluate the role of zinc and vitamin A supplementation in the recovery of Indigenous children hospitalised for acute diarrhoea. Design: A randomised controlled 2 by 2 factorial trial of supplementation with zinc and vitamin A. Setting and participants: Aboriginal children (aged < 11 years) hospitalised for acute diarrhoea at Alice Springs Hospital, Northern Territory, April 2001–July 2002. Main outcome measures: Duration of diarrhoeal illness; re‐admission for diarrhoeal illness within 120 days. Results: Our study involved 392 Aboriginal children with 436 episodes of diarrhoea. Supplementation with zinc, vitamin A, or combined zinc and vitamin A had no significant effect on duration of diarrhoea or rate of re‐admission compared with placebo. Median diarrhoea duration after starting supplementation was 3.0 days for the vitamin A and zinc supplemented and placebo groups ( P values 0.25 and 0.69, respectively). The number of re‐admissions did not differ significantly between those receiving vitamin A or zinc and the relevant placebo groups (relative risk [95% CI], 1.2 [0.7–2.1] and 1.3 [0.8–2.1], respectively). Conclusion: Vitamin A and zinc supplementation may not be indicated for in‐hospital management of acute diarrhoeal disease in Aboriginal children living in remote areas. This finding may not apply to children with malnutrition, for whom other studies suggest a benefit. Larger trials incorporating more comprehensive data on the vitamin A and zinc status as well as nutritional status of study populations might help to explain the different results in different populations.