Pilot zinc trial cuts infections 38% in Ugandan sickle-cell children

At Jinja Regional Referral Hospital in Uganda, Ruth Namazzi and Chandy John are studying a problem that can turn quickly serious for young children with sickle cell anemia: infection. In their randomized, double-blind, placebo-controlled pilot, 100 children aged 1 to 5 received either daily zinc or a placebo for six months. The zinc dose was 20 mg a day.

The difference appeared in the outcome the researchers were tracking. Children given zinc experienced a 38% reduction in all-cause infections compared with the placebo group, covering upper respiratory tract infections, diarrhea and bacterial infections. Sickle cell anemia produces misshapen red blood cells that obstruct the movement of oxygen, while zinc deficiency is common in affected children and can weaken the immune response.

The dose matters. An earlier study testing 10 mg of zinc daily found no reduction in infections; the new trial tested twice that amount. The supplement is also inexpensive: Chandy John said that, at large-volume prices, daily treatment could cost less than $3 a year per child.

So what changes in practice? If larger studies confirm the result, clinics could have a low-cost, readily available way to reduce infections among children with sickle cell anemia, potentially lowering illness and hospitalizations. But the researchers are not yet recommending zinc as standard care. The pilot must be validated across multiple sites, with older children included and the most effective dose weighed against side effects.

The study was led by scientists at Indiana University School of Medicine and partners in Uganda, including Namazzi, a Makerere University lecturer and research director at Global Health Uganda. Its findings were published in the Journal of the American Medical Association; the next step is confirmation in a larger population, not immediate rollout as established treatment.