EFFICACY OF ADJUVANT ZINC SUPPLEMENTATION IN SEVERE PNEUMONIA AMONG CHILDREN AGED 2– 60 MONTHS: A DOUBLE-BLIND RANDOMIZED CONTROLLED TRIAL

Abstract

Background:
Severe pneumonia remains a major cause of morbidity and mortality among children under five years of age, especially in low- and middle-income countries. Zinc, an essential trace element, has immunomodulatory properties that may improve clinical outcomes in pediatric pneumonia. This study aimed to evaluate the efficacy of adjuvant zinc supplementation in reducing treatment failure and duration of hospital stay in children with severe pneumonia.

Methods:
This double-blind randomized controlled trial was conducted among 100 children aged 2 to 60 months diagnosed with severe pneumonia, admitted to a tertiary care hospital. Participants were randomized into two groups: Group A (n=50) received oral zinc sulfate (10 mg/day for 2–6 months, 20 mg/day for >6 months) along with standard pneumonia treatment, while Group B (n=50) received a placebo. The primary outcome was treatment failure within 5 days of admission. Secondary outcomes included duration of hospital stay, oxygen requirement, ICU admission, and mortality. Data were analyzed using Chi-square test, Mann–Whitney U test, and logistic regression.

Results:
Treatment failure occurred in 6% of children in the zinc group versus 26% in the placebo group (p=0.006). Median duration of hospital stay was significantly shorter in the zinc group (3 days vs. 5 days; p<0.001). Fewer children in the zinc group required ICU admission (2% vs. 10%) or died (2% vs. 6%), though these differences were not statistically significant. Logistic regression showed that lack of zinc supplementation (aOR=5.54, 95% CI: 1.33–22.97) and elevated CRP (>20 mg/L) (aOR=4.34, 95% CI: 1.24–15.16) were independent predictors of treatment failure.

Conclusion:
Adjuvant zinc supplementation significantly reduced treatment failure and duration of hospitalization in children with severe pneumonia. Routine zinc administration may be beneficial as an adjunct to standard pneumonia management in this age group.