Pneumonia is one of the three most important causes of childhood deaths worldwide. Routine zinc administration to children in developing countries reduces the incidence of pneumonia and diarrhea. Thus, identification of realistic means to improve zinc nutriture in these children is warranted. Zinc has to be ingested every day, increasing the zinc intake of young infants, who are supposed to be exclusively breastfed is accordingly difficult. Therapeutic oral zinc administration during an ongoing infection, however, is incompatible with current breastfeeding recommendations and might be a feasible alternative to counteract the consequences of poor zinc nutriture. The benefits of therapeutic oral zinc given to children with diarrhea are well documented but the therapeutic effect of zinc when given during pneumonia or other severe bacterial illnesses has yet to be demonstrated. Furthermore, even short courses of zinc have been shown to reduce childhood morbidity for up to six months and may become an alternative to long/term zinc supplementation. We wish to assess the efficacy of oral zinc given during pneumonia in hospitalized and in non/hospitalized children 2 to 35 months of age and during severe bacterial illness in children less than 2 months of age on the severity of the enrollment episode and on subsequent morbidity and nutritional status for six months. Thus, the objective of the proposed project is to identify a community based and health facility based approach to improve zinc nutriture and to reduce the consequences of zinc deficiency in children with pneumonia or severe bacterial illness. If proven to be as effective as oral zinc supplementation during acute diarrhea, this new therapeutic micronutrient intervention strategy could rapidly be translated into a cost/effective and feasible primary care/based intervention to enhance child nutrition and survival from pneumonia or other severe bacterial illnesses in developing countries.
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