Effect of Preventive Supplementation with Zinc and Other Micronutrients on Non-Malarial Morbidity in Tanzanian Pre-School Children A Randomized Trial 英文参考文献.docVIP

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Effect of Preventive Supplementation with Zinc and Other Micronutrients on Non-Malarial Morbidity in Tanzanian Pre-School Children A Randomized Trial 英文参考文献.doc

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Effect of Preventive Supplementation with Zinc and Other Micronutrients on Non-Malarial Morbidity in Tanzanian Pre-School Children A Randomized Trial 英文参考文献

EffectofPreventiveSupplementationwithZincand OtherMicronutrientsonNon-MalarialMorbidityin TanzanianPre-SchoolChildren:ARandomizedTrial JacobienVeenemans1,2,LauraR.A.Schouten1,MaartenJ.Ottenhof1,TheoG.Mank3,DonaldR.A.Uges4, ErastoV.Mbugi1,5,Ays?e Y.Demir6,RobJ.Kraaijenhagen6,HuubF.J.Savelkoul1,HansVerhoef1,7* 1CellBiologyand Immunology Group,Wageningen University, Wageningen, The Netherlands, 2Laboratory for MicrobiologyandInfectionControl, Amphia Hospital, Breda,TheNetherlands,3DepartmentofParasitology,PublicHealthLaboratory,Haarlem,TheNetherlands,4LaboratoryforClinicalandForensicToxicologyandDrug Analysis,DepartmentofPharmacy,UniversityMedicalCenter,UniversityofGroningen,Groningen,TheNetherlands,5MuhimbiliUniversityofHealthandAlliedSciences, Dar es Salaam, Tanzania, 6Laboratory for Clinical Chemistry and Haematology, Meander Medical Centre, Amersfoort, The Netherlands, 7MRC International Nutrition Group,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom Abstract Background: The efficacy of preventive zinc supplementation against diarrhea and respiratory illness may depend on simultaneoussupplementationwithothermicronutrients.Weaimedtoassesstheeffectofsupplementationwithzincand multiplemicronutrientsondiarrheaandothercausesofnon-malarialmorbidity. MethodsandFindings:RuralTanzanianchildren(n=612)aged6–60monthsandwithheight-for-agez-score,–1.5SD wererandomizedtodailysupplementationwithzinc(10mg)alone,multi-nutrientswithoutzinc,multi-nutrientswithzinc, or placebo. Children were followed for an average of 45 weeks. During follow-up, we recorded morbidity episodes. We foundnoevidencethatconcurrentsupplementationwithmulti-nutrientsinfluencedthemagnitudeoftheeffectofzincon ratesofdiarrhea,respiratoryillness,feverwithoutlocalizingsigns,orotherillness(guardian-reportedillnesswithsymptoms involvingskin,ears,eyesandabscesses,butexcludingtraumaorburns).Zincsupplementationreducedthehazardrateof diarrhea by 24% (4%–40%). By contrast, multi-nutrients seemed to increas