Browsing by Author "Mushi, Sophia M."

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    The Effect of Zinc Supplementation in ChildrenRecovering from Severe Protein Energy Malnutrition at Muhimbili Medical Center
    (University of Dar es Salaam, 1997) Mushi, Sophia M.
    Study Objective To determine the effects of zinc supplementation in children recovering from severe Protein energy malnutrition (PEM). Study Design A randomised controlled clinical trial. Setting The study was conducted at the Nutritional Rehabilitation Unit (NURU) popularly known as Makuti ward at MuhimbiliMedical Centre, from July 1996 to January 1997. Subjects A total of 66 children aged between 12 to 60 months who had recovered from severe PEM, were recruited for the study. Methodology Children were randomized into two groups; supplemented and unsupplemented group. 33 children were supplemented with zinc sulphate 2 mg/kg daily and 33 received placebo. The two groups were further matched for nutritional diagnosis for example each case of kwashiorkor in the supplemented group wasmatched with another case of kwashiorkor in the unsupplemented group. Both groups were followed monthly for three months during which time zinc plasma levels were determined by Atomic absorption spectrophotometry. Weight and height were taken on recruitment and fortnightly for three months. History of intercurrent infections on admission andduring fortnightly follow up was obtained from the mother/caretaker. Main Outcome Measures The main outcome measures were increment of plasrna zinc level, weight, length, and decrease of morbidity. Results Overall (45/66) 74% of the children were found to be zinc deficient at the beginning of the study. The mean plasma zinc level on recruitment was O .470 mg/l in supplemented group and O. 387 mg/l in the unsupplemented group, however the difference in the mean plasma zinc levels between the 2 groups was statistically not significant (t 1.54, p=0.13). The mean plasrna zinc level on the 90th day of rehabilitation was higher in the supplemented group than in the unsupplemented group. The difference was statistically highly significant (t = 7.22, P < 0.001).At the end of 90 days of rehabilitation period the mean weight and the mean length in the supplemented children was greater than that in the unsupplemented group and the difference in weight was statistically significant (F value = 9.4, P value = 0.003) , however, the difference in length was statistically not significant, (x2 = 0.849, p = 0.35). The morbidity due to pneumonia and diarrhea decreased substantially in the supplemented group compared to that in the unsupplemented group and the difference was statistically significant. Conclusion and recommendations Zinc supplementation in children recovering from severe PEM has a positive effect on plasma zinc level, weight, and infant morbidity. It is recommended that children recovering from severe PEM should be supplemented with zinc.