IAJPS 2020, 07 (09), 130-133 Asif Khan et al ISSN 2349-7750

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INDO AMERICAN JOURNAL OF

PHARMACEUTICAL SCIENCES
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http://doi.org/10.5281/zenodo.4013091

Available online at: http://www.iajps.com Research Article

ANALYSIS OF IMPORTANCE OF ZINC

SUPPLEMENTATION IN THE TREATMENT OF
PNEUMONIA IN CHILDREN AGED 2 TO 5 YEARS
Dr. Asif Khan1, Dr. Rida Fatima2, Dr. Hafiza Zarka Yaqoob3
1
Khyber Medical College, Peshawar
2
Woman Medical Officer at Fazle Omer Hospital Rabwah
3
Woman Medical Officer at THQ Sanglahill
Article Received: July 2020 Accepted: August 2020 Published: September 2020
Abstract:
Aim: The aim of the study was to compare the average duration of treatment with and without zinc supplements
as an adjunct to antibiotic therapy of pneumonia in children aged 2 to 5 years.
Study Design: A randomized controlled trial.
Place and Duration: The study was conducted in the Pediatric Medicine department of Capital Hospital,
Islamabad for one year duration from May 2019 to April 2020.
Method: A non-probability purposive sampling technique was used in this study. After approval by the hospital's
ethics committee, 150 children meeting the selection criteria were registered. Parental consent was obtained.
Demographic data (age, name, address and gender) was obtained. The children were divided randomly into 2
groups by the lottery method. Group A received only standard antimicrobial therapy (ceftriaxone). Group Z
received zinc as adjunct therapy and standard antibiotics (ceftriaxone). Oral zinc was administered in doses of
10 mg once a day to children less than one year and 10 mg two times a day to children over 1 year. Recovery time
was observed from the start of treatment until the symptoms disappeared. Both groups were compared for mean
recovery time using an independent sample t.e <0.05 was considered significant.
Results: 150 cases were selected for the study. The children average age was 29.14 ± 16.60 months, and the
minimum and maximum age was 2 months and 5 years. The results of the study showed that 47% of patients are
men and 53% are women. 75 (50%) patients with temperature resolution and 75 (50%) patients without
temperature resolution appeared in this study. While solubility of tachypnea was observed in 65% of patients, it
was not observed in 35% of patients.
Conclusion: Adding zinc as an adjunct to typical treatment of pneumonia is beneficial in reducing the course of
treatment. In addition, it is useful to shorten the duration of the symptoms of the disease.
Key words: children, duration of treatment, pneumonia, standard antibiotic, zinc supplement.
Corresponding author:
Dr. Asif Khan, QR code
Khyber Medical College, Peshawar

Please cite this article in press Asif Khan et al, Analysis Of Importance Of Zinc Supplementation In The
Treatment Of Pneumonia In Children Aged 2 To 5 Years., Indo Am. J. P. Sci, 2020; 07(09).

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 IAJPS 2020, 07 (09), 130-133 Asif Khan et al ISSN 2349-7750

This randomized controlled study was held in the

Pediatric Medicine department of Capital Hospital,
INTRODUCTION: Islamabad for one year duration from May 2019 to
Pneumonia remains the foremost root of infant April 2020. Sample size of 150 cases; Zinc
mortality and accounts for around 20% of the 10 supplements as an additional supplement to
million deaths worldwide each year1. Pneumonia is antibiotic therapy of pneumonia in 2 months to 5
accountable for over 2 million neonatal deaths years children, with 95% confidence interval, 90%
annually in children under the age of 5 years and strength of study and duration of treatment, i.e. 4.6
accounts for 22% of yearly expiries in this group of ± 0.125 days with zinc and 6.84 ± 0.269 days
age in developed countries2. The estimated without zinc in each group. The sampling technique
incidence of clinical pneumonia below 5 years used is non-probable, targeted sampling method.
children is 0.30 episodes per child. Pneumonia is an The study included 2 months to 5 years of age
infectious inflammatory process, often involving children who were hospitalized with a diagnosis of
alveoli and lung airway structures. Treatment pneumonia. After obtaining the consent of the
involves the use of empirical antibiotics and hospital's ethics committee, 150 children meeting
complementary therapy (oxygen, intravenous fluids, the selection criteria were enrolled and informed
and nebulization) as required. The zinc role as an parental consent was obtained. Demographic
adjunct to pneumonia management is controversial3. information (name, age, gender, address) was
The Srinivasan study showed that adjuvant zinc obtained. The children were divided into two groups
therapy reduced mortality in severe childhood using the lottery method. Groups A received only
pneumonia. Another study conducted in Beijing standard antimicrobial therapy (ceftriaxone). Group
China showed that the recovery time after traditional Z received zinc as complementary therapy and
treatment in children given zinc was 4.6 ± 0.125 standard antibiotics (ceftriaxone). Oral zinc was
days and 6.84 ± 0.269 days without zinc administered in doses of 10 mg once a day among
supplements (p value = <0.05) On the contrary, a below one year children and 10 mg two times a day
randomized controlled study showed low but to above one year children. The recovery period was
statistically insignificant zinc activity in hospitalized observed from the beginning of treatment until the
children from 2 to 35 months of age4-5. The median symptoms disappeared (according to the operational
recovery time in the group given additional zinc definition). All information has been saved to the
treatment was 49 days and 55 days without zinc predefined proforma. All collected information was
supplements (p-value = 0.22). analyzed and entered in SPSS version 21.
Quantitative data such as recovery time and age is
A recent Nepal study has shown that adjuvant zinc presented as standard deviation and mean.
does not decrease the treatment failure risk or speed Qualitative data, such as gender, is obtainable as
up severe or non-severe pneumonia recovery6. The percentage and frequency. Using an independent t-
logic of this study is the publication of only two test, both groups were compared for mean recovery
studies in Pakistan, one of which has shown good time. A p value <0.05 was measured significant.
results with zinc supplementation, and the other has Stratification of age and sex was performed.
no effect on the duration of pneumonia by addition
of zinc. This work has been done to resolve this RESULTS:
confusion7. The diagnosis is compliant with WHO A total of 150 cases were selected for the study. The
criteria, namely fever (temperature> 98.6oF), average age of the children was 29.14 ± 16.60
cough, chest in drawing, cyanosis, nasal flaring and months, and the minimum and maximum age was 2
tachypnea (RR> 50 / min <1 year and min> 40/1 to months and 5 years. The results of the study showed
5 years). The tachypnea symptom was obligatory, that 47% of patients are men and 53% are women.
with 2 or more symptoms. Duration of treatment was 75 (50%) patients with temperature resolution and
measured in days from admission to resolution of 75 (50%) patients without temperature resolution
pneumonia, i.e. resolution of fever (temperature = appeared in this study. While solubility of tachypnea
98.6 ° F) and resolution of tachypnea for at least 24 was observed in 65% of patients, it was not observed
hours8. in 35% of patients. The mean time duration of the
patients was eminent as 5.15±1.40 days with
MATERIALS AND METHOD: maximum and minimum values of 3 & 8 days
correspondingly.

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 IAJPS 2020, 07 (09), 130-133 Asif Khan et al ISSN 2349-7750

Table I: Distribution of genders given treatment in Zinc and without Zinc Group
Zinc group (n=75) Non-Zinc group (n=75)
M F M F
40 35 30 45
Average Duration of treatment
Zinc Group 4.35 ± 1.19 days
Non-Zinc Group 5.89 ± 1.31 days
In this study, the treatment average duration in the zinc group was 4.35 ± 1.19 days, while the mean time in the
non-zinc group was 5.89 ± 1.31 days. A statistically substantial variance was found between the study groups.
The results of the study showed that 75 patients were from the zinc group, of which 35 were girls and 40 were
boys, and in the 75 patients of the non-zinc group, were 30 boys and 45 girls. A statistically insignificant difference
was found. In this study, the zinc group patients mean age was eminent as 29.08±17.55 days where in without
zinc group study groups. i.e., p-value=0.93
Table II: Mean & SD of the Group are Given
Study group with zinc Study group A Without zinc
n 75 75
Mean 4.35 5.89
SD 1.19 1.31

DISCUSSION: Palle Valentiner-Branth et al found that adjuvant

Acute respiratory tract infections (ARIs), especially zinc treatment does not decrease the treatment
diarrhea and pneumonia are the 2 leading reasons of failure risk or enhance retrieval in the event of non-
death in countries having low-income. severe or severe pneumonia attacks. No variance in
Supplementation with zinc supplements as an time to recovery between placebo and zinc group for
antibiotic supplement did not have a noteworthy non-severe (hazard ratio: 1.0; median: 2 d; CI95%,
influence on the recovery time of children with 1.1, 0.96) or severe (hazard ratio: 1.1; median: 4 d;
pneumonia9. Zinc deficiency child’s are more prone CI 95%: 1.5, 0.79) pneumonia14. However, one
to bacterial diseases and die more often. The study in Bangladesh showed a significant difference
estimated annual pneumonia incidence is 150 between regularization of respiratory rate (39 to 48
million new cases per annul (Rudan 2010), of which hours in the placebo and zinc groups). In our study,
every year 2 million die10. It is the major killer, patient registration was observed as 5.4 ± 1.38 days.
which represents 20% of all deaths of child in The mean disease duration in the zinc group at the
countries having low-income (Bryce 2011; Rudan time of enrollment in the Vellore study was 5.8 ±
2010), and recent neonatal pneumonia estimates 12.0 days and in the placebo group it was 4.8 ± 6.2
designate that it accounts for 29-34% of deaths in days. It is almost three days lengthier than the mean
children under the age of five years worldwide11. period of illness in Bangladesh. During enrollment,
The results of our study showed that the duration of a lengthier illness duration may designate that in the
patients receiving zinc supplements was shorter than Vellore trial children were in recovery at admission
those who did not take zinc supplements. Our study or have milder illnesses15. However, for Vellore, a
found a significant difference between the study treatment failure five times higher, it seems unlikely
groups and the duration of patients. Some studies that the disease in this study will be milder than the
confirm our results, but some are controversial12. In Bangladesh study.
2013, Brooks assessed the consequence of 20 mg
zinc supplementation given daily on clinical CONCLUSION:
improvement in children managed for severe Thus, it was found that zinc supplementation as an
pneumonia with IV antibiotics. Zinc does not affect addition to the standard treatment of pneumonia is
the severe recovery from pneumonia13. In 2013, beneficial for shortening the course of treatment and
Bose study also looked at the effects of zinc is also useful for shortening the duration of disease
supplementation 20 mg daily in children treated for symptoms. Now, in the future, we can use zinc
severe pneumonia with intravenous gentamicin and supplements for the early pneumonia treatment in
benzyl penicillin and the overall zinc children under 6 years old.
supplementation impact on length of hospital stay or
clinical recovery. REFRENCES:

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