Zinc supplements for preventing otitis media (Review)

Article English OPEN
Abba, Katharine ; Gulani, Anjana ; Sachdev, Harshpal S (2010)

Background\ud Otitis media (inflammation of the middle ear, usually caused by infection) affects people of all ages, but is particularly common in young children. Around 164 million people worldwide have long-term hearing loss caused by this condition, 90% of them in low-income countries. Because zinc supplements prevent pneumonia in disadvantaged children, we wondered whether they prevent otitis media.\ud \ud Objectives\ud To evaluate whether zinc supplements prevent otitis media in adults and children of different ages.\ud \ud Search strategy\ud We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, issue 2) which includes the Acute Respiratory Infection Groups' Specialised Register; MEDLINE (1950 to June Week 1 2009); and EMBASE (1974 to June 2009).\ud \ud Selection criteria\ud Randomised, placebo-controlled trials of zinc supplements given at least once a week for at least a month for preventing otitis media.\ud \ud Data collection and analysis\ud Two review authors assessed the eligibility and methodological quality of the included trials, extracted and analysed data and wrote the review. We summarised results using risk ratios or rate ratios for dichotomous data and mean differences for continuous data. We combined trial results where appropriate.\ud \ud Main results\ud We identified 12 trials for inclusion, 10 of which contributed outcomes data. In trials of healthy children living in low-income communities, two trials did not demonstrate a significant difference between the zinc supplemented and placebo groups in the numbers of participants experiencing an episode of definite otitis media during follow up (3191 participants), while another trial showed a significantly lower incidence rate of otitis media in the zinc group (rate ratio 0.69, 95% confidence interval (CI) 0.61 to 0.79, n = 1621). A small trial of 39 infants undergoing treatment for severe malnutrition suggested a benefit of zinc on the mean number of episodes of otitis media (mean difference -1.12 episodes, 95% CI -2.21 to -0.03). Zinc supplements did not seem to cause any serious adverse events, but a small minority of children were reported to have vomited shortly after ingestion of the supplements.\ud \ud Authors' conclusions\ud Evidence on whether zinc supplementation can reduce the incidence of otitis media in healthy children under the age of five years living in low- and middle-income countries is mixed. There is some evidence of benefit in children being treated for marasmus, but this is based on one small trial and should therefore be treated with caution.
  • References (141)
    141 references, page 1 of 15

    Bhandari 2002 {published and unpublished data} ∗ Bhandari N, Bahl R, Taneja S, Strand T, Molbak K, Ulvik RJ, et al.Effect of routine zinc supplementation on pneumonia in children aged 6 months to 3 years: randomised controlled trial in an urban slum. BMJ 2002;324(7350):1358-61. Bhandari N, Bhal T, Taneja S, Strand T, Molbak K, Ulvik RJ, et al.Substantial reduction in severe diarrhoea morbidity by daily zinc supplementation in young north Indian children. Pediatrics 2002; 109(6):86-91.

    Bobat 2005 {published data only} Bobat R, Coovadia H, Stephen C, Naidoo KL, McKerrow N, Black RE, et al.Safety and efficacy of zinc supplementation in children with HIV-1 infection in South Africa: a randomised double-blind placebo-controlled trial. Lancet 2005;366:1862-7.

    Brooks 2005 {published data only} ∗ Brooks WA, Santosham M, Naheed A, Goswami D, Wahed MA, Diener-West M, et al.Effect of weekly zinc supplements on incidence of pneumonia and diarrhoea in children younger than 2 years in an urban, low-income population in Bangladesh: randomised controlled trial. Lancet 2005;366(9490):999-1004.

    Gardner 2005 {published data only} Gardner JM, Powell CA, Baker-Henningham H, Walker SP, Cole TJ, Grantham-McGregor SM. Zinc supplementation and psychosocial stimulation: effects on the development of undernourished Jamaican children. American Journal of Clinical Nutrition 2005;82(2):399-405.

    Heinig 2006 {published data only} Heinig MJ, Brown KH, Lonnerdal B, Dewey KG. Zinc supplementation does not affect growth, morbidity, or motorLind 2004 {published data only} ∗ Lind T, Lonnerdal B, Stenlund H, Gamayanti IL, Ismail, Seswandhana T, et al.A community-based randomised controlled trial of iron and zinc supplementation in Indonesian infants: effects of growth and development. American Journal of Clinical Nutrition 2004;80(3):729-36. Lind T, Lonnerdal B, Stenlund H, Ismail D, Seswandhana R, Ekstrom EC, et al.A community-based randomized controlled trial of iron and zinc supplementation in Indonesian Infants: interactions between iron and zinc. American Journal of Clinical Nutrition 2003;77(4):883-90.

    Muller 2001 {published data only} Muller O, Becher H, van Zweeden AB, Ye Y, Diallo DA, Konate AT, et al.Effect of zinc supplementation on malaria and other causes of morbidity in west African children: randomised double blind placebo controlled trial. BMJ 2001;322(7302):1567.

    Penny 2004 {published data only} Penny ME, Marin RM, Duran A, Peerson JM, Lanata CF, Lonnerdal B, et al.Randomized controlled trial of the effect of daily supplementation with zinc or multiple micronutrients on morbidity, growth, and micronutrient status of young Peruvian children. American Journal of Clinical Nutrition 79;3:457-65.

    Prasad 1999 {published data only} Prasad AS, Beck FWJ, Kaplan J, Pranatharthi H, Chandrasekar JO, Fitzgerald JT, et al.Effect of zinc supplementation on incidence of infections and hospital admissions in sickle cell disease. American Journal of Hematology 1999;61:194-202.

    Prasad 2007 {published data only} Prasad AS, Beck Fw, Bao B, Fitzgerald JT, Snell DC, Steinberg JD, et al.Zinc supplementation decreases incidence of infections and hospital admissions in sickle cell disease (SCD). American Journal of Hematology 1999;61(3):194-202.

    Schlesinger 1992 {published data only} Schlesinger L, Arevalo M, Arredondo AS, Diaz M, Lonnerdal B, Stekel A. Effect of a zinc-fortified formula on immunocompetence and growth of malnourished infants. American Journal of Clinical Nutrition 1992;56(3):491-8.

  • Metrics
    0
    views in OpenAIRE
    0
    views in local repository
    78
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    LSTM Online Archive - IRUS-UK 0 78
Share - Bookmark