Effect of Vitamin A and Zinc Supplementation on Gastrointestinal Parasitic Infections Among Mexican Children

[摘要] OBJECTIVE. Gastrointestinal parasites continue to be an important cause of morbidity and stunting among children in developing countries. We evaluated the effect of vitamin A and zinc supplementation on infections by Giardia lamblia , Ascaris lumbricoides , and Entamoeba histolytica .METHODS. A randomized, double-blind, placebo-controlled trial was conducted among 707 children who were 6 to 15 months of age and from periurban areas of Mexico City, Mexico, between January 2000 and May 2002. Children, who were assigned to receive either vitamin A every 2 months, a daily zinc supplement, a combined vitamin A and zinc supplement, or a placebo, were followed for 1 year. The primary end points were the 12-month rates and durations of infection for the 3 parasites and rates of parasite-associated diarrheal disease as determined in stools collected once a month and after diarrheal episodes.RESULTS. G lamblia infections were reduced and A lumbricoides infections increased among children in the combined vitamin A and zinc group or the zinc alone group, respectively. Durations of Giardia infections were reduced among children in all 3 treatment arms, whereas Ascaris infections were reduced in the vitamin A and zinc group. In contrast, E histolytica infection durations were longer among zinc-supplemented children. Finally, E histolytica –and A lumbricoides –associated diarrheal episodes were reduced among children who received zinc alone or a combined vitamin A and zinc supplement, respectively.CONCLUSIONS. We found that vitamin A and zinc supplementation was associated with distinct parasite-specific health outcomes. Vitamin A plus zinc reduces G lamblia incidence, whereas zinc supplementation increases A lumbricoides incidence but decreases E histolytica –associated diarrhea.

[学科分类] 儿科学