The effects of multivitamin and zinc supplementation on infectious morbidity in Tanzanian infants (389.5)

Abstract

Objective: To determine whether daily supplementation of Tanzanian infants with multivitamins (MV), zinc (Zn), or both (MV+Zn) lowers the risk of infectious morbidity compared with placebo.Methods: 2400 infants born to HIV‐negative mothers were randomly assigned to receive daily oral supplementation of MV (B complex, C and E), Zn, MV+Zn, or placebo from age 6 weeks for 18 months. Morbidity was assessed by study nurses at monthly visits and by physicians every 3 months and/or when the child was acutely ill.Results: Rates of diarrhea (RR=0.88; 95% CI=0.81, 0.96; p=0.004) and acute upper respiratory infection (RR=0.88; 95% CI=0.82, 0.95; p=0.0008), as diagnosed by study physicians, were 12% lower among infants who received Zn vs those who did not. The incidence of diarrhea, as reported at monthly visits, was 18% lower in the Zn only vs placebo group (RR=0.82; 95% CI=0.69, 0.98; p=0.03). There was a non‐significant increase in mortality among infants who received Zn (HR=1.80; 95% CI=0.98, 3.31; p=0.06). MV did not alter the occurrence of any recorded morbidities. Neither Zn nor MV reduced hospitalizations or unscheduled outpatient visits.Conclusion: Daily zinc supplementation from age 6 weeks may lower the burden of diarrhea and upper respiratory infections. Provision of multivitamins may not confer additional benefit.Grant Funding Source: Supported by NICHD R01 HD048969‐01