Please select the eligibility criteria that correspond to the clinical trial below.
Title: Role of Zinc in Recurrent Acute Lower Respiratory Infections
Brief Summary: Acute respiratory infections (ARIs) are the most frequent illnesses globally. Despite advances in the recognition and management ARIs, these account for over 20% of all child deaths globally.Trace mineral deficiencies have long been implicated in causation and consequences of many diseases. The importance of adequate zinc intake in human health is well documented and zinc deficiency is a large public health problem, especially among children in developing countries.Various studies suggest that zinc-deficient populations are at increased risk of developing diarrhoeal diseases, respiratory tract infections and growth retardation.Among the individual interventions zinc supplementation with universal coverage ranks 5th in preventing under five mortality in India, preceded only in order by breast feeding; complementary feeding; clean delivery; Hib vaccination; and clean water, sanitation and hygiene.Numerous studies have examined the association between child mortality and zinc deficiency. A number of randomized controlled trials evaluating effect of zinc supplementation have found the intervention to be beneficial in reducing ARI and diarrhoeal mortality and morbidity but few studies have found beneficial effect in diarrhea and no or even contrasting effects on morbidity pattern of acute respiratory infections. Whereas role of zinc in diarrhea is now a well established and specific guidelines and recommendations have been given for zinc supplementation in diarrhea, role of zinc in acute respiratory infections is controversial. The contrasting effect of zinc on diarrhoea and acute lower respiratory infection as reported in several studies is a public health concern, because zinc supplementation is carried out in many nutrition rehabilitation units. Further in many of randomized control trials supplement syrups also contained other vitamins, including vitamin A, known to have effect on respiratory morbidity. Most of the trials evaluating effect of zinc on respiratory morbidity and mortality are community based and children with well known causes of recurrent acute lower respiratory infections have not been excluded from the study pool.

Hence the current study was planned to bridge this gap of information and attempts to detect the role of zinc using "zinc only preparations" in reducing respiratory morbidity in children aged 6 to 59 months with recurrent acute lower respiratory infections.


Options:
A: Inclusion Criteria:

* Children aged 6 to 59 months with documented recurrent acute lower respiratory infection i.e., more than two episodes of ALRI in one year or more than three episodes in any time frame.

Exclusion Criteria:

* Children with congenital heart diseases
* Children with congenital anomalies which can cause recurrent chest infection
* Children with Tuberculosis
* Children with bronchial asthma or hyperactive airway disease
* Children with WZS \< -2 of HZS \< -2 as per WHO standards
* Children with any diarrhoeal episode in past 3 months
* Children having receive any zinc supplementation in past 3 months
* Children who did not turn up on follow up and could not be contacted were excluded from the study.
B: Inclusion Criteria:

* All children 1-35 months of age living in 30 Village Development Committees of Sarlahi District in southern Nepal.

Exclusion Criteria:

* Parent refusal
C: Inclusion Criteria:

* Children aged 2- 35 months with a history of cough (duration \<14days) and difficult breathing of \</= 72hours' duration, with lower chest indrawing.
* Availability of informed consent.

Exclusion Criteria:

* Children with severe wasting (\<70% NCHS median weight for height)
* Severe anemia (hemoglobin \<7 gm/dl.)
* Presence of heart disease with or without signs of cardiac failure.
* Child with a chronic cough (lasting for ≥14 days)
* Documented tuberculosis with ongoing treatment.
* Associated other severe diseases that require special care or surgical intervention.
* Children with concomitant diarrhea with some/severe dehydration
* Children with a history of recurrent wheezing
* Children enrolled in the study within the last 6 months of this visit
D: Inclusion Criteria:

4-6 months of age (stratified by HIV status) Infant able to take oral preparations Consent of parent/guardian HIV status obtained from mother and child

Exclusion Criteria:

Documented micronutrient supplementation other than vitamin A in the preceding month Less than 60% of mean weight for age by NCHS guidelines (micronutrient intervention obligatory according to WHO guidelines for management of severely malnourished children) Persistent diarrhea (\>=7 days) at the time of study enrollment Exclusive breastfeeding Infants in whom a second confirmatory HIV test cannot be obtained (when required) Co-enrollment of the infant in other clinical intervention trials e.g. antibiotic or vaccine trials

Answer: A