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Malaria rates in African children unaffected by zinc supplement regimen

Veenemans J. PLoS Med. 2011;doi:10.1371/journal.pmed.1001125.

Preventive zinc supplementation does not reduce rates of malarial infection in Tanzanian children, according to study results published in the November issue of PLoS Medicine. Further study analyses found that a zinc supplement regimen — in combination with multi-nutrient supplementation, including iron, folic acid, vitamin A, vitamin B12, vitamin B1, vitamin B2, copper and vitamin E — may have increased the incidence of first malaria episodes by approximately 30%.

In the study, researchers enrolled 612 rural Tanzanian children (aged 6 to 60 months) and randomly assigned them to receive daily oral supplements containing only zinc, multi-nutrients with zinc, multi-nutrients without zinc or a placebo. During the study period, there were 1,572 malaria episodes and researchers found that the incidence rate of malaria in all four intervention groups was nearly identical, with each group demonstrating about three episodes a year.

“Despite a high prevalence of zinc deficiency, excellent compliance, and few drop-outs, we found no evidence from this trial that preventive zinc supplementation, alone or with multi-nutrients, reduced rates of febrile attacks of malaria,” the researchers said in a press release.

Study results also suggest that an increase in overall malaria rates may have occurred in children with iron deficiency who received the multi-nutrient supplement. Among children with iron deficiency, multi-nutrients increased rates of malaria episodes by 41%, while they had no effect in those who were iron replete. The addition of an iron supplement among iron-deficient children — who demonstrate more efficient iron absorption than iron-replete children — may have provided a nutritional source for the proliferation of malaria parasites.

According to researchers, “Diverse lines of evidence suggest that, of all the micronutrients, iron is the most critical mediator of host–pathogen interactions, and our findings build on existing evidence suggesting that supplementation with iron can increase malaria risk.”

Disclosure: The researchers report no relevant financial disclosures.

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