description): The Vitamin A and Zinc - Prevention of Pneumonia (VAZPOP) Study. Linking Vitamin A and Zinc Deficiencies, Immunity, Growth, and the Prevention of the Leading Cause of Childhood Death. The objective is to delineate how vitamin A and zinc supplementation interact in improving immunity, fostering growth, and preventing infection, in populations at risk for malnutrition and vitamin A and zinc deficiency. Malnutrition is involved in half of the global deaths in children less than 5. Acute respiratory infection (ARI), especially acute lower respiratory infection (ALRI) or pneumonia, is the leading cause of death in children. The investigators propose to conduct a randomized, placebo controlled, double blind, nutritionally stratified study of low dose vitamin A, 10 mg/day elemental zinc, both, or placebo in 2,400 children in Quito Ecuador. They will test the hypotheses that: a) low-dose vitamin A has paradoxically positive and negative effects on ALRI in underweight and well nourished children; b) zinc will protect against ALRI and diarrhea while boosting cell mediated immunity; c) growth will be fostered by zinc (and potentially by vitamin A) in deficient children; and d) misclassification of ALRI cases can mask the benefits or risks of vitamin A. The investigators will use state-of- the-art field techniques to assess body composition and growth, and utilize sophisticated techniques to assess vitamin A and zinc deficiency. In addition, they will use rigorous definitions of ALRI/pneumoma to avoid misclassification and ascertainment bias, which may have affected prior studies.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD038327-05
Application #
6696886
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Grave, Gilman D
Project Start
2000-01-18
Project End
2005-12-31
Budget Start
2004-01-01
Budget End
2005-12-31
Support Year
5
Fiscal Year
2004
Total Cost
$440,583
Indirect Cost
Name
Tufts University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
039318308
City
Boston
State
MA
Country
United States
Zip Code
02111
Harris, Aaron M; Sempertegui, Fernando; Estrella, Bertha et al. (2011) Air pollution and anemia as risk factors for pneumonia in Ecuadorian children: a retrospective cohort analysis. Environ Health 10:93
Sempértegui, Fernando; Estrella, Bertha; Tucker, Katherine L et al. (2011) Metabolic syndrome in the elderly living in marginal peri-urban communities in Quito, Ecuador. Public Health Nutr 14:758-67
Egorov, Andrey I; Sempertegui, Fernando; Estrella, Bertha et al. (2010) The effect of Helicobacter pylori infection on growth velocity in young children from poor urban communities in Ecuador. Int J Infect Dis 14:e788-91
Brachtl, Megan V; Durant, John L; Perez, Carlos Paez et al. (2009) Spatial and temporal variations and mobile source emissions of polycyclic aromatic hydrocarbons in Quito, Ecuador. Environ Pollut 157:528-36
Hamer, Davidson H; Sempertegui, Fernando; Estrella, Bertha et al. (2009) Micronutrient deficiencies are associated with impaired immune response and higher burden of respiratory infections in elderly Ecuadorians. J Nutr 139:113-9
Naumova, Elena N; Yepes, Hugo; Griffiths, Jeffrey K et al. (2007) Emergency room visits for respiratory conditions in children increased after Guagua Pichincha volcanic eruptions in April 2000 in Quito, Ecuador observational study: time series analysis. Environ Health 6:21
Fefferman, Nina H; Naumova, Elena N (2006) Combinatorial decomposition of an outbreak signature. Math Biosci 202:269-87