ABSTRACT
Objectives: Meta-analyses find that supplemental zinc reduces the incidence of diarrhea and acute lower respiratory tract infections, but its effect on malaria is inconsistent. We assessed the effects of different amounts of zinc in SQ-LNS compared with zinc in a dispersible tablet on the incidence of diarrhea and malaria in young children in a community-based, double-blind, placebo controlled, randomized trial in rural, southwestern Burkina Faso. Methods: 2469 children 9 months of age, were assigned to receive one of four interventions: LNS without zinc and placebo tablet (LNS-Zn0; negative control), LNS with 5 mg zinc and placebo tablet (LNS-Zn5), LNS with 10 mg zinc and placebo tablet (LNS-Zn 10) and LNS without zinc and 5 mg zinc tablet (LNS-TabZn5; positive control). Children received 20 g of LNS and one placebo or zinc tablet daily for 9 months. Weekly morbidity surveillance was conducted at children's homes; malaria treatment was provided for confirmed malaria, and ORS provided for reported diarrhea. Results: Prevalence of malaria at baseline (59.4% overall) did not differ among groups. During the 9-month follow-up, the incidence of diarrhea was 1.15 (±1.18 SD) and the incidence of malaria was 0.55 (±0.54 SD) episodes per 100 child-days, and did not differ by treatment group (p=0.673 and p=0.535, respectively). Incidence of severe diarrhea and severe malaria also did not differ by treatment group. Conclusions: The inclusion of 5 or 10 mg zinc in SQ-LNS did not affect diarrhea or malaria morbidity compared to both positive and negative control groups in this population.