Zinc supplementation for the treatment of measles in children

被引:24
作者
Awotiwon, Ajibola A. [1 ]
Oduwole, Olabisi [2 ]
Sinha, Anju [3 ]
Okwundu, Charles I. [4 ]
机构
[1] Univ Cape Town, Knowledge Translat Unit, Lung Inst, George St, ZA-7700 Cape Town, Western Cape, South Africa
[2] Univ Calabar, ITDR P, Teaching Hosp, Calabar, Nigeria
[3] Indian Council Med Res, Div Child Hlth, Ansari Nagar, India
[4] Stellenbosch Univ, Ctr Evidence Based Hlth Care, Fac Med & Hlth Sci, Cape Town, South Africa
来源
COCHRANE DATABASE OF SYSTEMATIC REVIEWS | 2017年 / 06期
关键词
Measles [complications; mortality; *therapy; Pneumonia [therapy; Randomized Controlled Trials as Topic; Zinc [*administration & dosage; deficiency; Child; Humans; CONTROLLED TRIAL; PNEUMONIA; PREVENTION; DIARRHEA;
D O I
10.1002/14651858.CD011177.pub3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Measles is an important cause of childhood morbidity and mortality globally, despite increasing vaccine coverage. Zinc plays a significant role in the maintenance of normal immunological functions, therefore supplements given to zinc-deficient children will increase the availability of zinc and could reduce measles-related morbidity and mortality. This is an update of a review first published in 2015. Objectives To assess the effects of zinc supplementation in reducing morbidity and mortality in children with measles. Search methods We searched CENTRAL (03 February 2017, Issue 2), MEDLINE (1946 to 03 February 2017), Embase (1974 to 03 February 2017), CINAHL (1981 to 03 February 2017), LILACS (1982 to 03 February 2017), Web of Science (1985 to 03 February 2017), and BIOSIS Previews (1985 to 27 June 2014). We also searched ClinicalTrials.gov, the Australian New Zealand Clinical Trials Registry and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) on 03 February 2017 to identify unpublished and ongoing studies. Selection criteria Randomised controlled trials (RCTs) and quasi-RCTs evaluating the effects of zinc in reducing morbidity and mortality in children with measles. Data collection and analysis Two review authors independently assessed the studies for inclusion and extracted data on outcomes, details of the interventions, and other study characteristics using a standardised data extraction form. We used risk ratio (RR) and hazard ratio (HR) as measures of effect with 95% confidence intervals (CI). We included only one study, and did not conduct meta-analysis. Main results We did not identify any new studies for inclusion in this update. One RCT met our inclusion criteria. The study was conducted in India and included 85 children diagnosed with measles and pneumonia. The trial showed no significant difference in mortality between children with measles and pneumonia who received zinc supplements and those who received placebo (RR 0.34, 95% CI 0.01 to 8.14). There was no significant difference in time to absence of fever between children who received zinc supplements and those who did not (HR 1.08, 95% CI 0.67 to 1.74). No treatment-related side effects were reported in either group. We assessed the overall quality of the evidence as very low. Authors' conclusions We could not draw any definitive conclusions from this review about the effects of zinc supplementation on clinical outcomes of children with measles due to the very low quality of the evidence available. There is insufficient evidence to confirm or refute the effect of zinc supplementation in children with measles.
引用
收藏
页数:22
相关论文
共 11 条
[1]   Role of zinc administration in prevention of childhood diarrhea and respiratory illnesses: A meta-analysis [J].
Aggarwal, Rakesh ;
Sentz, John ;
Miller, Mark A. .
PEDIATRICS, 2007, 119 (06) :1120-1130
[2]  
Atkins D, 2004, BMJ-BRIT MED J, V328, P1490
[3]  
BACH JF, 1989, MED ONCOL TUMOR PHAR, V6, P25
[4]   Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: Pooled analysis of randomized controlled trials [J].
Bhutta, ZA ;
Black, RE ;
Brown, KH ;
Gardner, JM ;
Gore, S ;
Hidayat, A ;
Khatun, F ;
Martorell, R ;
Ninh, NX ;
Penny, ME ;
Rosado, JL ;
Roy, SK ;
Ruel, M ;
Sazawal, S ;
Shankar, A .
JOURNAL OF PEDIATRICS, 1999, 135 (06) :689-697
[5]   Measles still spreads in Europe: who is responsible for the failure to vaccinate? [J].
Carrillo-Santisteve, P. ;
Lopalco, P. L. .
CLINICAL MICROBIOLOGY AND INFECTION, 2012, 18 :50-56
[6]   Zinc and infection: a review [J].
Cuevas, LE ;
Koyanagi, A .
ANNALS OF TROPICAL PAEDIATRICS, 2005, 25 (03) :149-160
[7]  
GRADE Working Group McMaster University, 2016, GRADEPRO GDT
[8]  
Khaled MA, 2001, FASEB J, V15, pA610
[9]   Zinc supplementation as adjunct therapy in children with measles accompanied by pneumonia: a double-blind, randomized controlled trial [J].
Mahalanabis, D ;
Chowdhury, A ;
Jana, S ;
Bhattacharya, MK ;
Chakrabarti, MK ;
Wahed, MA ;
Khaled, MA .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 2002, 76 (03) :604-607
[10]  
Mahalanabis D, 2001, FASEB J, V15, pA1094