Pneumonia Clinical Trial
Official title:
Efficacy of Zinc as Adjuvant Therapy in the Treatment of Severe Pneumonia in Nepalese Children at the Kanti Children's Hospital
The aim of this study is to assess whether zinc given as adjuvant therapy to standard antibiotic treatment in children hospitalized for severe pneumonia reduces the duration of the severe illness and risk of treatment failure. A randomized double blind placebo controlled clinical trial will be conducted at the Kanti Hospital.
Nepal has an under-five mortality rate of 91/1000 live births. Pneumonia, one of the major
killers accounts for the death of 25,000 - 35,000 Nepalese children every year. It is
estimated that, on an average, of 1000 children <5 years of age that visit health
facilities, 90 have pneumonia of which 4.2 have severe pneumonia. At the Kanti Children's
Hospital, respiratory diseases are the most frequent reason for admission and the second
most frequent cause of child death Zinc, an important micronutrient, is crucial for the
normal function of the immune system as well as the integrity of the respiratory epithelium.
Zinc deficiency is associated with an increased incidence and severity of diarrhea and
respiratory tract infections. The preventive effect of zinc on diarrheal and respiratory
illness has been well documented.
Early in an infection zinc is shifted into the liver from the plasma, bone, skin and
intestines. For a child with initial low zinc levels, even relatively trivial infections may
cause entry into the vicious cycle of reduced plasma zinc and increased infection severity.
Administration of zinc during the acute illness may help in reducing the severity of
illness.
The therapeutic effect of zinc in acute diarrhea has been well documented. In a study
conducted at Bhaktapur, Nepal, in children 6 to 36 months of age, supplementation with zinc
was found to be highly effective in the treatment of acute diarrhea.
The Kanti Children's Hospital in Kathmandu serves as a general and referral hospital for
children from all parts of the country. Approximately 25% of all admissions to this hospital
are due to pneumonia. Being the only well recognized children's hospital, there is always a
constraint for available beds for children presenting with pneumonia. Zinc as an adjuvant to
standard treatment of pneumonia with antimicrobials was found to hasten recovery from severe
pneumonia in children less than 2 years of age in Bangladesh . If we were to conduct a
similar study and prove that zinc does in fact help to shorten the duration of illness in
children with severe pneumonia, it would go a long way in contributing to improve case
management.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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