{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:50:00Z","timestamp":1781279400595,"version":"3.54.1"},"reference-count":48,"publisher":"Cambridge University Press (CUP)","issue":"S2","license":[{"start":{"date-parts":[[2007,3,9]],"date-time":"2007-03-09T00:00:00Z","timestamp":1173398400000},"content-version":"unspecified","delay-in-days":2138,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Nutr"],"published-print":{"date-parts":[[2001,5]]},"abstract":"<jats:p>Role of micronutrients namely vitamin A, zinc and folate, as adjunct therapy of illness episodes in children in developing countries have been discussed in the light of health policy. Apart from a selective review, attempts have been made to statistically combine results of several studies to address policy issues. In children, vitamin A supplementation during illness has (a) a profound effect in reducing mortality in measles, (b) possibly a significant effect in reducing persistent diarrhea episodes in children with acute diarrhea, and (c) no benefit in pneumonia.<\/jats:p><jats:p>Use of large dose vitamin A is recommended during measles episodes but not in non-measles pneumonia. Its use in acute diarrhea is debatable but recommended in persistent diarrhea and in severe malnutrition as a component of a micronutrient mixture. Large dose vitamin A supplementation should be used with caution in young infants as there are unresolved concerns about its safety particularly, bulging fontanelle observed in infants when co-administered at immunization. In children, zinc supplementation during illness, (a) had a marked effect in reducing prolonged episodes and a modest effect on episode duration in acute diarrhea, (b) resulted in reduced rate of treatment failure and death in persistent diarrhea, (c) had no effect in measles and non-measles pneumonia, and (d) probably had a detrimental effect of increasing death rate when a large dose was used in severely malnourished children. The desirability of routine zinc supplementation therapy of undernourished children with acute diarrhea should be assessed further. Concerning policy, zinc supplementation as a component of a micronutrient mixture is recommended in the rehabilitation of severely malnourished children and in persistent diarrhea. However, recommendation for its routine use in all cases of acute diarrhea in children needs additional studies on effectiveness, cost, operations and safety. In two randomized controlled trials folate has been evaluated in acute and persistent diarrhea and found to have no beneficial effect. Folate is not recommended as adjunct therapy of diarrhea. Role of folate in preventing severe disease and\/or death deserves further evaluation.<\/jats:p>","DOI":"10.1079\/bjn2000308","type":"journal-article","created":{"date-parts":[[2009,10,7]],"date-time":"2009-10-07T17:38:18Z","timestamp":1254937098000},"page":"S151-S158","source":"Crossref","is-referenced-by-count":14,"title":["Micronutrients as adjunct therapy of acute illness in children: impact on the episode outcome and policy implications of current findings"],"prefix":"10.1017","volume":"85","author":[{"given":"Dilip","family":"Mahalanabis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maharaj K.","family":"Bhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2007,3,9]]},"reference":[{"key":"S0007114501001052_ref029","doi-asserted-by":"publisher","DOI":"10.1016\/S0271-5317(97)00035-3"},{"key":"S0007114501001052_ref028","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70416-7"},{"key":"S0007114501001052_ref018","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1242\/dev.111.4.1081","article-title":"Complex regulation of TGF (expression by retinoic acid in the vitamin A deficient rat)","volume":"111","author":"Glick","year":"1991","journal-title":"Development"},{"key":"S0007114501001052_ref034","first-page":"585","article-title":"Effect of zinc on leucocyte sodium transport in vitro","volume":"54","author":"Patrick","year":"1978","journal-title":"Clinical Science and Molecular Medicine"},{"key":"S0007114501001052_ref012","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/68.3.742"},{"key":"S0007114501001052_ref009","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/54.5.890"},{"key":"S0007114501001052_ref019","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/BF00840325","article-title":"Effect of vitamin A deficiency on permeability of the small intestine mucosa for macromolecules in adult rats","volume":"103","author":"Gmoshinaldi","year":"1987","journal-title":"Bulletin of Experimental and Biological Medicine"},{"key":"S0007114501001052_ref040","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199509283331304"},{"key":"S0007114501001052_ref037","first-page":"439","article-title":"Administration of 25,000 IU vitamin A doses at routine immunization in young infants","volume":"49","author":"Rahman","year":"1995","journal-title":"European Journal of Clinical Nutrition"},{"key":"S0007114501001052_ref013","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.3745.708"},{"key":"S0007114501001052_ref021","doi-asserted-by":"publisher","DOI":"10.2307\/2530643"},{"key":"S0007114501001052_ref031","doi-asserted-by":"publisher","DOI":"10.3181\/00379727-176-41845"},{"key":"S0007114501001052_ref038","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/108.12.1983"},{"key":"S0007114501001052_ref048","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70086-7"},{"key":"S0007114501001052_ref008","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(88)80627-9"},{"key":"S0007114501001052_ref004","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.294.6567.294"},{"key":"S0007114501001052_ref035","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/33.3.617"},{"key":"S0007114501001052_ref039","article-title":"The impact of zinc deficiency on the intestinal response to cholera toxin","volume":"45","author":"Roy","year":"1986","journal-title":"Proceedings of Nutritional Society"},{"key":"S0007114501001052_ref003","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1995.tb13781.x"},{"key":"S0007114501001052_ref016","unstructured":"Fawzi WW , Moise RL , Fataks M , Herrera MG , Kawau F & Ndossi G (1996) Effect of vitamin A supplements in reducing seventy of lower respiratory infections among children in Tanzania. Presented to the meeting of the International Vitamin A Consultative Group in Guatemala in March 1996. Guatemala, IVACG (Abstract No. XVII)."},{"key":"S0007114501001052_ref011","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90136-Z"},{"key":"S0007114501001052_ref007","doi-asserted-by":"publisher","DOI":"10.1079\/BJN2000304"},{"key":"S0007114501001052_ref033","doi-asserted-by":"publisher","DOI":"10.1136\/gut.33.6.794"},{"key":"S0007114501001052_ref025","first-page":"437","article-title":"Lack of therapeutic efficacy of vitamin A for non-cholera, watery diarrhea in Bangladeshi children","volume":"46","author":"Henning","year":"1992","journal-title":"European Journal of Clinical Nutrition"},{"key":"S0007114501001052_ref005","first-page":"17","article-title":"Effectiveness of vitamin A supplementation in the control of young child morbidity and mortality in developing countries","volume":"9","author":"Beaton","year":"1993","journal-title":"SCN NEWS"},{"key":"S0007114501001052_ref047","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/107.4.552"},{"key":"S0007114501001052_ref041","doi-asserted-by":"publisher","DOI":"10.1016\/0271-5317(96)00027-9"},{"key":"S0007114501001052_ref023","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)92384-7"},{"key":"S0007114501001052_ref022","unstructured":"Gudas IJ , Sporn MB , Robert AB (1994) Cellular biology and biochemistry of the retinoids. In The Retinoids: Biology, Chemistry and Medicine, pp. 443\u2013520. [ Sporn MB , Robert AB and Goodman DS , editors]. New York: Raven Press."},{"key":"S0007114501001052_ref026","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7129.422"},{"key":"S0007114501001052_ref030","first-page":"719","article-title":"Statistical aspects of the analysis of data from retrospective studies of disease","volume":"22","author":"Mantel","year":"1959","journal-title":"Journal of National Cancer Institute"},{"key":"S0007114501001052_ref043","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(79)90037-3"},{"key":"S0007114501001052_ref036","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1996.02170260029004"},{"key":"S0007114501001052_ref002","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1111\/j.1651-2227.1998.tb00916.x","article-title":"Folic acid in the treatment of acute watery diarrhea in children: a double-blind, randomized, controlled trial","volume":"87","author":"Ashraf","year":"1998","journal-title":"Acta Paediatrica"},{"key":"S0007114501001052_ref014","first-page":"1","article-title":"Double-blind, randomized, controlled trial of zinc or vitamin A supplementation in young children with acute diarrhea","volume":"87","author":"Faruque","year":"1998","journal-title":"Acta P\u00e6diatrica"},{"key":"S0007114501001052_ref044","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)32078-8"},{"key":"S0007114501001052_ref020","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/34.5.900"},{"key":"S0007114501001052_ref001","doi-asserted-by":"publisher","DOI":"10.1079\/BJN19900122"},{"key":"S0007114501001052_ref015","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/37.1.31"},{"key":"S0007114501001052_ref017","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-198409000-00022"},{"key":"S0007114501001052_ref032","first-page":"1008","article-title":"Randomised, double blind, placebo controlled clinical trial of efficacy of vitamin A treatment in non-measles childhood pneumonia","volume":"13","author":"Nacul","year":"1997","journal-title":"British Medical Journal"},{"key":"S0007114501001052_ref042","first-page":"73","article-title":"No evidence of fontanelle-bulging episodes after vitamin A supplementation of 6- and 9-month-old infants in Guinea Bissau","volume":"49","author":"Stabell-Benn","year":"1995","journal-title":"European Journal of Clinical Nutrition"},{"key":"S0007114501001052_ref046","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)02487-8"},{"key":"S0007114501001052_ref045","doi-asserted-by":"publisher","DOI":"10.1136\/gut.42.3.396"},{"key":"S0007114501001052_ref006","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/127.1.59"},{"key":"S0007114501001052_ref027","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199007193230304"},{"key":"S0007114501001052_ref010","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)91648-6"},{"key":"S0007114501001052_ref024","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/65.1.160"}],"container-title":["British Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007114501001052","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T00:01:45Z","timestamp":1633996905000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007114501001052\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,5]]},"references-count":48,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2001,5]]}},"alternative-id":["S0007114501001052"],"URL":"https:\/\/doi.org\/10.1079\/bjn2000308","relation":{},"ISSN":["0007-1145","1475-2662"],"issn-type":[{"value":"0007-1145","type":"print"},{"value":"1475-2662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,5]]}}}