A six-month randomised trial found that 20mg of zinc sulphate a day reduced infections in young Ugandan children with sickle cell anaemia, though larger studies are needed before wider use can be recommended.
A daily zinc supplement may help cut infection rates in young children with sickle cell anaemia, according to a randomised clinical trial in JAMA that studied children in Uganda. The findings suggest that 20 mg of zinc sulphate a day could offer an extra layer of protection for a group that faces a high risk of illness and death from infection, although the researchers said larger, multi-centre studies are still needed before the approach can be recommended more widely.
The trial, led by Ruth Namazzi of Makerere University College of Health Sciences in Kampala, was carried out at Jinja Regional Referral Hospital and enrolled children aged between one and 4.99 years. Of 118 screened, 100 were randomly assigned to receive zinc or a placebo for six months, with 50 children in each group. All of the children were on or started hydroxyurea during the study, a standard treatment used to reduce complications of sickle cell disease and one that may have influenced the background risk of infection.
By the end of follow-up, children given zinc had 80 infections, compared with 124 in the placebo group. The rate of infection was 305.7 per 100 person-years in the zinc group and 480.7 per 100 person-years among those taking placebo. After adjusting for age, sex and hydroxyurea use, the researchers reported that infection incidence was 38% lower in the zinc arm. No participant had an adverse event serious enough to stop the assigned treatment, and all 100 children completed the study.
The new findings add to a mixed evidence base. A previous Ugandan trial involving 252 young children tested 10 mg of zinc daily for 12 months and found no meaningful reduction in severe or invasive infections, suggesting that dose, duration and the type of infection measured may matter. Even so, the latest JAMA study points to a potentially practical, low-cost intervention in a setting where recurrent infections remain a major burden for families and health services. The authors said further trials across several centres, and in older children as well, are needed to determine whether the benefit holds up in broader use.
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