Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months

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dc.contributor.authorChhagan, Meera Ken_ZA
dc.contributor.authorVan den Broeck, Janen_ZA
dc.contributor.authorLuabeya, Kany-Kany Aen_ZA
dc.contributor.authorMpontshane, Nontobekoen_ZA
dc.contributor.authorTomkins, Andrewen_ZA
dc.contributor.authorBennish, Michaelen_ZA
dc.date.accessioned2015-11-11T11:57:22Z
dc.date.available2015-11-11T11:57:22Z
dc.date.issued2010en_ZA
dc.description.abstractBACKGROUND: The benefits of zinc or multiple micronutrient supplementations in African children are uncertain. African children may differ from other populations of children in developing countries because of differences in the prevalence of zinc deficiency, low birth weight and preterm delivery, recurrent or chronic infections such as HIV, or the quality of complementary diets and genetic polymorphisms affecting iron metabolism.The aim of this study was to ascertain whether adding zinc or multiple micronutrients to vitamin A supplementation improves longitudinal growth or reduces prevalence of anemia in children aged 6-24 months. METHODS: Randomized, controlled double-blinded trial of prophylactic micronutrient supplementation to children aged 6-24 months. Children in three cohorts - 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers, and 187 uninfected children born to HIV-uninfected mothers - were separately randomly assigned to receive daily vitamin A (VA) [n = 124], vitamin A plus zinc (VAZ) [n = 123], or multiple micronutrients that included vitamin A and zinc (MM) [n = 126]. RESULTS: Among all children there were no significant differences between intervention arms in length-for-age Z scores (LAZ) changes over 18 months. Among stunted children (LAZ below -2) [n = 62], those receiving MM had a 0.7 Z-score improvement in LAZ versus declines of 0.3 in VAZ and 0.2 in VA (P = 0.029 when comparing effects of treatment over time). In the 154 HIV-uninfected children, MM ameliorated the effect of repeated diarrhea on growth. Among those experiencing more than six episodes, those receiving MM had no decline in LAZ compared to 0.5 and 0.6 Z-score declines in children receiving VAZ and VA respectively (P = 0.06 for treatment by time interaction). After 12 months, there was 24% reduction in proportion of children with anemia (hemoglobin below 11 g/dL) in MM arm (P = 0.001), 11% in VAZ (P = 0.131) and 18% in VA (P = 0.019). Although the within arm changes were significant; the between-group differences were not significant. CONCLUSIONS: Daily multiple micronutrient supplementation combined with vitamin A was beneficial in improving growth among children with stunting, compared to vitamin A alone or to vitamin A plus zinc. Effects on anemia require further study.TRIAL REGISTRATION:This study is registered with ClinicalTrials.gov, number .NCT00156832.en_ZA
dc.identifier.apacitationChhagan, M. K., Van den Broeck, J., Luabeya, K. A., Mpontshane, N., Tomkins, A., & Bennish, M. (2010). Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months. <i>BMC Public Health</i>, http://hdl.handle.net/11427/14870en_ZA
dc.identifier.chicagocitationChhagan, Meera K, Jan Van den Broeck, Kany-Kany A Luabeya, Nontobeko Mpontshane, Andrew Tomkins, and Michael Bennish "Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months." <i>BMC Public Health</i> (2010) http://hdl.handle.net/11427/14870en_ZA
dc.identifier.citationChhagan, M. K., Van den Broeck, J., Luabeya, K. K. A., Mpontshane, N., Tomkins, A., & Bennish, M. L. (2010). Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months. BMC Public Health, 10(1), 145.en_ZA
dc.identifier.ris TY - Journal Article AU - Chhagan, Meera K AU - Van den Broeck, Jan AU - Luabeya, Kany-Kany A AU - Mpontshane, Nontobeko AU - Tomkins, Andrew AU - Bennish, Michael AB - BACKGROUND: The benefits of zinc or multiple micronutrient supplementations in African children are uncertain. African children may differ from other populations of children in developing countries because of differences in the prevalence of zinc deficiency, low birth weight and preterm delivery, recurrent or chronic infections such as HIV, or the quality of complementary diets and genetic polymorphisms affecting iron metabolism.The aim of this study was to ascertain whether adding zinc or multiple micronutrients to vitamin A supplementation improves longitudinal growth or reduces prevalence of anemia in children aged 6-24 months. METHODS: Randomized, controlled double-blinded trial of prophylactic micronutrient supplementation to children aged 6-24 months. Children in three cohorts - 32 HIV-infected children, 154 HIV-uninfected children born to HIV-infected mothers, and 187 uninfected children born to HIV-uninfected mothers - were separately randomly assigned to receive daily vitamin A (VA) [n = 124], vitamin A plus zinc (VAZ) [n = 123], or multiple micronutrients that included vitamin A and zinc (MM) [n = 126]. RESULTS: Among all children there were no significant differences between intervention arms in length-for-age Z scores (LAZ) changes over 18 months. Among stunted children (LAZ below -2) [n = 62], those receiving MM had a 0.7 Z-score improvement in LAZ versus declines of 0.3 in VAZ and 0.2 in VA (P = 0.029 when comparing effects of treatment over time). In the 154 HIV-uninfected children, MM ameliorated the effect of repeated diarrhea on growth. Among those experiencing more than six episodes, those receiving MM had no decline in LAZ compared to 0.5 and 0.6 Z-score declines in children receiving VAZ and VA respectively (P = 0.06 for treatment by time interaction). After 12 months, there was 24% reduction in proportion of children with anemia (hemoglobin below 11 g/dL) in MM arm (P = 0.001), 11% in VAZ (P = 0.131) and 18% in VA (P = 0.019). Although the within arm changes were significant; the between-group differences were not significant. CONCLUSIONS: Daily multiple micronutrient supplementation combined with vitamin A was beneficial in improving growth among children with stunting, compared to vitamin A alone or to vitamin A plus zinc. Effects on anemia require further study.TRIAL REGISTRATION:This study is registered with ClinicalTrials.gov, number .NCT00156832. DA - 2010 DB - OpenUCT DO - 10.1186/1471-2458-10-145 DP - University of Cape Town J1 - BMC Public Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months TI - Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months UR - http://hdl.handle.net/11427/14870 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14870
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2458-10-145
dc.identifier.vancouvercitationChhagan MK, Van den Broeck J, Luabeya KA, Mpontshane N, Tomkins A, Bennish M. Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months. BMC Public Health. 2010; http://hdl.handle.net/11427/14870.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2010 Chhagan et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Public Healthen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcpublichealth/en_ZA
dc.subject.otherAnthropometryen_ZA
dc.subject.otherDietary Supplementsen_ZA
dc.subject.otherMicronutrientsen_ZA
dc.titleEffect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 monthsen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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