Effect of zinc on the treatment of Plasmodium falciparum malaria in children: A randomized controlled trial

Fernando Sempértegui, Bertha Estrella, Franklin R. Toapanta, Darwin S. Torres, Dheyanira E. Calahorrano, Kojo Yeboah-Antwi, Emmanuel Addo-Yobo, Paul Arthur, Sam Newton, Zul Premji, Mloka Hubert, Cyprian S. Makwaya, Freddie Ssengooba, Joseph Konde-Lule, Emmanuel Mukisa, Davidson H. Hamer, William MacLeod, Christopher Duggan, Wafaie Fawzi, Jonathon SimonVictor Mwanakasale, Modest Mulenga, Thomas Sukwa, John Tshiula

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41 Citations (Scopus)


Background: Zinc supplementation in young children has been associated with reductions in the incidence and severity of diarrheal diseases, acute respiratory infections, and malaria. Objective: The objective was to evaluate the potential role of zinc as an adjunct in the treatment of acute, uncomplicated falciparum malaria; a multicenter, double-blind, randomized placebo-controlled clinical trial was undertaken. Design: Children (n = 1087) aged 6 mo to 5 y were enrolled at sites in Ecuador, Ghana, Tanzania, Uganda, and Zambia. Children with fever and ≥ 2000 asexual forms of Plasmodium falciparum/μL in a thick blood smear received chloroquine and were randomly assigned to receive zinc (20 mg/d for infants, 40 mg/d for older children) or placebo for 4 d. Results: There was no effect of zinc on the median time to reduction of fever (zinc group: 24.2 h; placebo group: 24.0 h; P = 0.37), a ≥75% reduction in parasitemia from baseline in the first 72 h in 73.4% of the zinc group and in 77.6% of the placebo group (P = 0.11), and no significant change in hemoglobin concentration during the 3-d period of hospitalization and the 4 wk of follow-up. Mean plasma zinc concentrations were low in all children at baseline (zinc group: 8.54 ± 3.93 μmol/L; placebo group: 8.34 ± 3.25 μmol/L), but children who received zinc supplementation had higher plasma zinc concentrations at 72 h than did those who received placebo (10.95 ± 3.63 compared with 10.16 ± 3.25 μmol/L, P < 0.001). Conclusion: Zinc does not appear to provide a beneficial effect in the treatment of acute, uncomplicated falciparum malaria in preschool children.

Original languageEnglish
Pages (from-to)805-812
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Issue number4
Publication statusPublished - Oct 2002
Externally publishedYes


  • Africa
  • Ecuador
  • Malaria
  • Plasmodium falciparum
  • Preschool children
  • Zinc


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