Evidence map›Paper›PMID 24835009›Full record

Trial reportPloS one2014

Village-randomized clinical trial of home distribution of zinc for treatment of childhood diarrhea in rural Western kenya.

Daniel R Feikin, Godfrey Bigogo, Allan Audi, Sherri L Pals, George Aol, Charles Mbakaya, John Williamson, Robert F Breiman, Charles P Larson

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00530829 (Clinical Effectiveness and Preventive Impact of Home Zinc Treatment for Acute Diarrhea in Children), which is not on this map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00530829 phase3completednot on this map

Clinical Effectiveness and Preventive Impact of Home Zinc Treatment for Acute Diarrhea in Children: A Cluster-randomized Field Trial in Rural Western Kenya

TypeinterventionalSponsorCenters for Disease Control and PreventionRan2007 to 2009Enrolled3,000ConditionsDiarrheaArmszinc
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Daniel R FeikinInternational Emerging Infections Program, Centers for Disease Control and Prevention Kisumu, Kenya.
Godfrey BigogoInternational Emerging Infections Program, Centers for Disease Control and Prevention Kisumu, Kenya; Kenya Medical Research Institute, Nairobi, Kenya.
Allan AudiInternational Emerging Infections Program, Centers for Disease Control and Prevention Kisumu, Kenya; Kenya Medical Research Institute, Nairobi, Kenya.
Sherri L PalsDivision of Global HIV/AIDS, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
George AolInternational Emerging Infections Program, Centers for Disease Control and Prevention Kisumu, Kenya; Kenya Medical Research Institute, Nairobi, Kenya.
Charles MbakayaKenya Medical Research Institute, Nairobi, Kenya.
John WilliamsonCenter for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Robert F BreimanInternational Emerging Infections Program, Centers for Disease Control and Prevention Kisumu, Kenya.
Charles P LarsonInternational Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; Department of Pediatrics, University of British Columbia, Vancouver, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundZinc treatment shortens diarrhea episodes and can prevent future episodes. In rural Africa, most children with diarrhea are not brought to health facilities. In a village-randomized trial in rural Kenya, we assessed if zinc treatment might have a community-level preventive effect on diarrhea incidence if available at home versus only at health facilities.

methodsWe randomized 16 Kenyan villages (1,903 eligible children) to receive a 10-day course of zinc and two oral rehydration solution (ORS) sachets every two months at home and 17 villages (2,241 eligible children) to receive ORS at home, but zinc at the health-facility only. Children's caretakers were educated in zinc/ORS use by village workers, both unblinded to intervention arm. We evaluated whether incidence of diarrhea and acute lower respiratory illness (ALRI) reported at biweekly home visits and presenting to clinic were lower in zinc villages, using poisson regression adjusting for baseline disease rates, distance to clinic, and children's age.

resultsThere were no differences between village groups in diarrhea incidence either reported at the home or presenting to clinic. In zinc villages (1,440 children analyzed), 61.2% of diarrheal episodes were treated with zinc, compared to 5.4% in comparison villages (1,584 children analyzed, p<0.0001). There were no differences in ORS use between zinc (59.6%) and comparison villages (58.8%). Among children with fever or cough without diarrhea, zinc use was low (<0.5%). There was a lower incidence of reported ALRI in zinc villages (adjusted RR 0.68, 95% CI 0.46-0.99), but not presenting at clinic.

conclusionsIn this study, home zinc use to treat diarrhea did not decrease disease rates in the community. However, with proper training, availability of zinc at home could lead to more episodes of pediatric diarrhea being treated with zinc in parts of rural Africa where healthcare utilization is low.

trial registrationClinicalTrials.gov NCT00530829.

Indexed as

ChildDiarrheaFluid TherapyHome Infusion TherapyHumansKenyaRegression AnalysisRural PopulationZincZinc

Identifiers

PMID24835009
PMCPMC4023937

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.