Résumé
Objectives: To determine the prevalence and risk factors of zinc deficiency among young children in rural south-western Burkina Faso. Methods: We collected socio-economic, demographic, feeding practice and morbidity information from a sample of 473 children 6-18 mo of age residing in southern Orodara health district; and measured plasma zinc concentration (PZC) by ICP-AES and C-reactive protein and alpha-1 acid glycoprotein by ELISA to adjust PZC for inflammation. Zinc deficiency was defined as PZC ˂ 65μg/L. Associations between selected risk factors and low PZC were screened in bivariate analyses and assessed by generalized multivariable logistic regression. Results: Mean adjusted PZC was 68.4±13.1 ug/L, and the prevalence of zinc deficiency was 43.5% [95%CI: 38.4-48.7]. The odds of zinc deficiency was significantly higher in households with no livestock ownership as compared to the two highest quintiles of livestock ownership (OR= 2.4- 2.5, p<0.05) and when more households shared the family compound (OR= 1.8, p<0.026 for 3-4 households as compared to 1 household per compound). Religion was also associated with zinc deficiency, but recent child morbidity history and feeding practices were not. Conclusions: There is a high prevalence of zinc deficiency among young children in rural southwestern Burkina Faso, especially among children living in large family compounds. Homestead livestock rearing and possibly some religious/cultural habits may reduce the risk of zinc deficiency.
Résumé
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.