Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions
Daniel E Roth, Laura E Caulfield, Majid Ezzati, Robert E Black
Volume 86, Number 5, May 2008, 356-364
Table 2. Estimated effects of selected nutritional interventions on ALRI incidence, morbidity or mortality
| Nutritional intervention | ALRI outcome | Effect sizea | Source | Comments |
|---|---|---|---|---|
| Incidence | 0.95 (0.89–1.01) | Meta-analysis of five trials |
Recent systematic review confirmed the null effects on incidence and mortality |
|
| Mortality | 0.98 (0.75–1.28) | Meta-analysis of five trials |
||
| Incidence | 0.80 (0.70–0.92) | Meta-analysis of four trials |
Included trials of supplementation for at least 3 months | |
| Mortality | 0.85 (0.65–1.11) | Unpublished meta-analysis of three trials |
Effect size (95% CI) in individual trials:Bangladesh – cannot calculate relative rate [10 deaths in placebo group (n = 812) and 0 in zinc arm (n = 809)];Nepal 0.90 (0.64–1.26);United Republic of Tanzania 0.88 (0.5–1.5) | |
| Hospitalization | 0.85 (0.57–1.27) | Single large trial in Belarus |
Outcome ascertained by maternal recall | |
| Incidence | 0.97 (0.83–1.23) | Meta-analysis of eight trials |
Trials published since the meta-analysis have confirmed the null effect |
|
| Incidence | 0.92 (0.7–1.09) | Single large trial in Nepal |
In a companion trial conducted in a malaria-endemic region (Pemba), iron-folic acid (with or without zinc) significantly increased the risk of death due to non-malarial infections (HR 1.61, 95% CI: 1.03–2.52), although the specific effect on ALRI mortality was not estimated |
|
| Mortality | 0·88 (0.50–1.46) | Single large trial in Nepal |
||
| Incidence | 0.91 (0.76–1.08) | Single large trial in Nepal |
||
| Mortality | 0.80 (0.45–1.34) | Single large trial in Nepal |
||
| Incidence | 0.74 (0.57–0.97) | Single trial in India |
Experimental milk contained higher concentrations of vitamins A, E, C, iron, zinc, selenium and copper than the control milk | |
ALRI, acute lower respiratory infection; CI, confidence interval; HR, hazard ratio.a Relative risk or relative rate, odds ratio or hazard ratio, compared with placebo. Values in parentheses are 95% CI.