Zinc-sepsis

Zinc as an adjunct for the treatment of clinical serious infection in young infants

Severe infections, including sepsis and severe pneumonia, contribute to almost one quarter of the deaths in infants up to two months of age. This is despite available – although not always accessible – antibiotic therapy, and the problem is likely to be aggravated as antibiotic resistance continues to spread. In a recent randomized controlled trial in India, which was anchored at the Translational Health Science and Technology Institute (THSTI), CISMAC researchers found that a daily dose of zinc given to infants aged 7 to 120 days under antibiotic treatment for probable serious bacterial infection increased the success of treatment by 43%. The trial was not powered to estimate the effect of zinc on their risk of dying. With collateral funding from RCN’s GLOBVAC programme, we are now undertaking a much larger trial, this time in infants younger than two months of age, also with clinically suspected sepsis. Enrolling 4.140 children, this trial is powered to estimate the efficacy of zinc to improve survival rates when it is given in addition to antibiotics. The trial is being undertaken in three hospitals in Nepal and four hospitals in New Delhi with CISMAC partners THSTI in India and the Institute of Medicine, Tribhuvan University in Nepal. Being used routinely for treatment of children with diarrhoea, zinc is widely accessible; it is also very cheap. Should the adjunct zinc treatment prove to be effective in increasing the survival chances of these vulnerable babies, our study will provide important evidence for improving the treatment guidelines for sepsis, thereby contributing to enhanced survival of young infants in LMIC.

Project Management Team

Principal Investigators
SUDHA BASNET is a pediatrician with considerable clinical and research experience in child health in Nepal. Basnet has made significant contributions to the design, implementation, analyses and dissemination of two large randomized controlled trials (community based and hospital based) on zinc as adjunct treatment of pneumonia in young children. Basnet is currently a Postdoctoral fellow at the Centre for International Health/Department of Global Public Health and Primary Care, UiB and Associate Professor of Pediatrics, Tribhuvan University Institute of Medicine, Nepal.
NITYA WADHWA is a Scientist at the Paediatric Biology Centre at the Translational Health Science and Technology Institute (THSTI), Faridabad, India. Wadhwa transitioned from a clinical career to research in 2005. In her initial five years as a clinical researcher, she was involved in implementing hypothesis-driven studies that evaluated interventions directed at commonly-occurring infections in children in India. In 2010 she joined the Paediatric Biology Centre at THSTI as a Clinical Investigator, leading a multicenter study of immune profiling in cord blood. Since then she has collaborated with the biologists at THSTI on several projects aimed at understanding the development and maturation of the neonatal and infant immune system.
Co-Principal Investigator
TOR A STRAND has a longstanding research interest in immunity, infection and nutrition. His work has focused on zinc, B vitamins and vitamin D and common childhood infections such as diarrhea and pneumonia. He has undertaken clinical trials of micronutrient supplementation to prevent diarrheal and respiratory infections, as well as studies on the aetiology, natural history and risk factors of pneumonia and severe bacterial illnesses. Micronutrient deficiencies, inflammation and infections are all risk factors for poor neurodevelopment and growth in young children, and these are the focus of many of his ongoing studies. He is a research professor at Innlandet Hospital Trust, University of Bergen, and Innlandet University of Applied Sciences.

 RESEARCHERS

Kailash C Aggarwal

Vardhman Mavhir Medical college

Anup Mohta

Chacha Nehru Bal Chikitsalaya

Imran Ansari

Tribhuvan

Uma Chandra Mouli Natchu

THSTI

Srijana Basnet

Tribhuvan

Siddarth Ramji

Mualana Azas Medical college

Shinjini Bhatnagar

THSTI

Ganesh Prasad Shah

Thribhuvan

Meenakshi Bhatt

Vardhman Mavhir Medical college

Binod Man Shrestha

Thribhuvan

Ram Hari Chapagain

Tribhuvan

Laxman Shrestha

Thribhuvan

Harish Chellani

Vardhman Mavhir Medical college

Halvor Sommerfelt

UiB

Anuradha Govil

Chacha Nehru Bal Chikitsalaya

 

 

Mamta Jajoo

Chacha Nehru Bal Chikitsalaya

PHD CANDIDATE

 

 

Nitin B Mathur

Mualana Azas Medical college

Johanne Haugen

UiB/IHT

 

 Countries: India and Nepal