Effect of preventive supplementation with zinc and other micronutrients on non-malarial morbidity in Tanzanian pre-school children: a randomized trial
Veenemans, J. ; Schouten, L.R.A. ; Ottenhof, M. ; Mank, T. ; Uges, D.R.A. ; Mbugi, E.V. ; Demir, A.Y. ; Kraaijenhagen, R.J. ; Savelkoul, H.F.J. ; Verhoef, J.C.M. - \ 2012
PLoS ONE 7 (2012)8. - ISSN 1932-6203
iron supplementation - prepubertal children - caco-2 - growth - interventions - permeability - vitamins - alters - copper - cells
Background The efficacy of preventive zinc supplementation against diarrhea and respiratory illness may depend on simultaneous supplementation with other micronutrients. We aimed to assess the effect of supplementation with zinc and multiple micronutrients on diarrhea and other causes of non-malarial morbidity. Methods and Findings Rural Tanzanian children (n = 612) aged 6–60 months and with height-for-age z-score <–1.5 SD were randomized to daily supplementation with zinc (10 mg) alone, multi-nutrients without zinc, multi-nutrients with zinc, or placebo. Children were followed for an average of 45 weeks. During follow-up, we recorded morbidity episodes. We found no evidence that concurrent supplementation with multi-nutrients influenced the magnitude of the effect of zinc on rates of diarrhea, respiratory illness, fever without localizing signs, or other illness (guardian-reported illness with symptoms involving skin, ears, eyes and abscesses, but excluding trauma or burns). Zinc supplementation reduced the hazard rate of diarrhea by 24% (4%–40%). By contrast, multi-nutrients seemed to increase this rate (HR; 95% CI: 1.19; 0.94–1.50), particularly in children with asymptomatic Giardia infection at baseline (2.03; 1.24–3.32). Zinc also protected against episodes of fever without localizing signs (0.75; 0.57–0.96), but we found no evidence that it reduced the overall number of clinic visits. Conclusions We found no evidence that the efficacy of zinc supplements in reducing diarrhea rates is enhanced by concurrent supplementation with other micronutrients. By reducing rates of fever without localizing signs, supplementation with zinc may reduce inappropriate drug use with anti-malarial medications and antibiotics.
|Glycosphingolipids and insulin resistance
Aerts, J.M. ; Boot, R.G. ; Eijk, M. van; Groener, J. ; Bijl, N. ; Lombardo, E. ; Bietrix, F.M. ; Dekker, N. ; Groen, A.K. ; Ottenhof, M. ; Roomen, C. ; Aten, J. ; Serlie, M. ; Langeveld, M. ; Wennekes, T. ; Overkleeft, H.S. - \ 2011
In: Sphingolipids and Metabolic Disease Landes Bioscience and Springer Science+Business Media - p. 99 - 119.
Protection against diarrhea associated with Giardia intestinalis is lost with Multi-Nutrient Supplementation: A Study in Tanzanian Children
Veenemans, J. ; Mank, T. ; Ottenhof, M. ; Baidjoe, A.Y. ; Mbugi, E.V. ; Demir, A.Y. ; Wielders, J.P.M. ; Savelkoul, H.F.J. ; Verhoef, J.C.M. - \ 2011
PLoS Neglected Tropical Diseases 5 (2011)6. - ISSN 1935-2727 - 10 p.
israeli bedouin infants - lamblia infection - protozoal parasites - helicobacter-pylori - natural-history - young-children - bangladesh - childhood - disease - consequences
Background - Asymptomatic carriage of Giardia intestinalis is highly prevalent among children in developing countries, and evidence regarding its role as a diarrhea-causing agent in these settings is controversial. Impaired linear growth and cognition have been associated with giardiasis, presumably mediated by malabsorption of nutrients. In a prospective cohort study, we aim to compare diarrhea rates in pre-school children with and without Giardia infection. Because the study was conducted in the context of an intervention trial assessing the effects of multi-nutrients on morbidity, we also assessed how supplementation influenced the relationship between Giardia and diarrhoea rates, and to what extent Giardia modifies the intervention effect on nutritional status. Methods and Findings - Data were collected in the context of a randomized placebo-controlled efficacy trial with 2×2 factorial design assessing the effects of zinc and/or multi-micronutrients on morbidity (n = 612; height-for-age z-score