The Effect of Vitamin A And Zinc or Vitamin A, Zinc & Multivitamin Supplementation on Morbidity Due to Malaria

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Interventions with vitamin A or zinc have been shown in various studies to reduce incidences of malaria and other illness. However the effect of supplementing with vitamin A, Zinc and multivitamins has not been studied. We measured the effect of combining vitamin A, zinc and multivitamins on malaria morbidity. A randomized, controlled trial was conducted in children in the Ejusu-Juaben Municipality of Ghana. Children (n=542) aged between 6 to 60 months were randomly assigned to 1 of 3 intervention groups; group 1, control - vitamin A (single dose 200 000 IU), group 2-vitamin A (single dose 200 000 IU) & zinc (10 mg daily), group 3-vitamin A (single dose 200 000 IU) with multivitamin (according to age) and zinc (10mg daily). Malaria episodes were detected by surveillance or cases self-reported to a community health worker. Cross-sectional surveys were conducted at the beginning and the end of the study period. The primary outcome was an episode of malaria (temperature ≥37.5°C) which was confirmed by microscopy and testing with a rapid test kit for malaria antigen (HRP2) of plasmodium falciparium. The risk of malaria infection among the children who received vitamin A, zinc & multivitamin during the study period was reduced to 62% (RR = 0.62, p = 0.018) of the risk in children who received vitamin A alone. The risk of children who received vitamin A & zinc was 81% though this decrease was not significant (RR = 0.81, p = 0.109).The children in the vitamin A alone group had the highest geometric mean parasite density the end of the study. Amongst the groups, it took those in the vitamin A, zinc & multivitamin group a longer time (112 days) to develop the first episode of malaria compared to the vitamin A alone group (93days, p = 0.004); differences in time to develop malaria between the other groups were not significant.; vitamin A & zinc; 94 days and vitamin A; 93 days. The results suggest that combined supplementation with vitamin A, zinc and multivitamins reduces the risk of malaria infection appreciably.
A Thesis submitted to Department of Biochemistry And Biotechnology, Kwame Nkrumah University of Science And Technology-Kumasi in partial fulfillment of the requirements for the degree of MASTER OF PHILOSOPHY College Of Science. February,2013