3Masinde Muliro University of Science and Technology, Kakamega, Kenya

Prosper Chopera PhD1, Valeria Galetti PhD2, Elizabeth Opiyo Anyango MSc,3 Viktor Jakab MSc2, Simone Heeb MSc2, Pauline Andang’o PhD4, Inge D Brouwer PhD1, Michael B Zimmerman MD, PhD2, Diego Moretti PhD2

1Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV Wageningen, The Netherlands/University of Zimbabwe, PO Box MP 167 Mt Pleasant, Harare
2Laboratory of Human Nutrition, Instituteof Food, Nutrition and Health, ETH Zurich, Schmelzbergstrasse 7, 8092 Zurich, Switzerland

3Masinde Muliro University of Science and Technology, Kakamega, Kenya

4Maseno University, Maseno Kenya

Abstract (260 words)

Introduction: Zinc is an important micronutrient necessary for all body functions particularly the immune system [1]. Zinc deficiency and diarrhea are highly prevalent and coexist in children from developing countries [2]. A promising novel option for delivering zinc in diarrhea endemic, zinc deficient communities is through microbiologically treated, zinc fortified water provided with a household based fortification and filtration device [3].

Objectives: Our objective was to assess the effectiveness of zinc fortified filtered water to improve zinc intake and status, and reduce morbidity in children aged 2-6 years from rural Western Kenya

Methods: We randomly allocated 184 children (2-6 years) to receive either zinc fortified filtered water or filtered water with no zinc daily for 6 months. The main outcome measure was dietary zinc intake. Secondary outcomes were plasma zinc concentration (PZn), morbidity and growth. Dietary zinc intake was assessed using a quantitative multi-pass 24hr recall. Secondary outcomes were measured at baseline, midpoint and endpoint except morbidity which was assessed weekly by means of a questionnaire.

Results: Zinc fortified water contributed 42% and 36% of daily requirements for absorbable zinc in children 2-3 and 4-6 years respectively. A time treatment interaction effect was obtained on overall morbidity (p<0.001); RR (95%CI) =0.91 (0.87, 0.96) morbidity due to cold (p=0.034) RR (95%CI) =0.91(0.83, 0.99) and stomach pain (p=0.003) RR (95%CI) =0.70(0.56, 0.89). There was no treatment effect on plasma zinc concentration.

Conclusion: Daily consumption of zinc fortified, microbiologically treated water could have significant public heath impact in improving dietary zinc intake and preventing general childhood infections in preschool children in rural Africa.

References

1. Shankar AH: Zinc and immune function:The biological basis of altered resistance to infection. Am J Clin Nutr 1998, 68 Suppl:447S–463S.

2. Lindenmayer GW, Stoltzfus RJ, Prendergast AJ: Interactions between Zinc Deficiency and Environmental Enteropathy in Developing Countries. Adv Nutr An Int Rev J 2014, 5 (1 ):1–6.

3. Galetti V, Kujinga P, Mitchikpè CES, Zeder C, Tay F, Tossou F, Hounhouigan JD, Zimmermann MB, Moretti D: Efficacy of highly bioavailable zinc from fortified water: a randomized controlled trial in rural Beninese children. Am J Clin Nutr 2015, 102:1238–48.