Response to Our Article Entitled “Zinc Supplementation and the Prevention and Treatment of Sepsis in Young Infants: A Systematic Review and Meta-Analysis”

Dear Dr. Halliday,

Thank you for sharing the letter by Eduardo Villamor in response to our article entitled “Zinc Supplementation and the Prevention and Treatment of Sepsis in Young Infants: A Systematic Review and Meta-Analysis” in Neonatology. He pointed out a possible duplication of subjects in the papers referring to the studies reported from India. We have now thoroughly investigated this matter and have had several communications with Dr. Bhat regarding their reports and it has taken us some time to unravel the issue.

Banupriya et al. [1-3] conducted a trial in India on zinc supplementation between 2013 and 2016 from which they published three separate papers. In these three publications, they reported two different clinical trial registry IDs as well as different enrollment periods, creating major confusion as to these being discrete studies. As indicated by Villamor, this was not the first time the 3 reports were considered as 3 separate trials, and unfortunately our search strategy did not turn up Dr. Villamor’s letter [4]. Following his recent letter, we directly approached Dr. Vishnu Bhat, the corresponding author of the three papers in question and asked for tracking by individual subjects. It became apparent that these were sequential publications reporting on the same subjects in duplicate. We have therefore corrected our analysis and inclusion of subject from his studies, only using data from the latest and hopefully final publication [3].

This change has significant implications for our paper which appears on-line, and some of the conclusions and statements therein, although the main messages remain unchanged. We have attempted to update all the relevant text, numbers of children and studies, effect estimates, GRADE, and overall conclusions and have rebuilt all the figures and tables. The exact changes made appear in the appendix below and in the corrected version of the paper.

We regret the inconvenience but are grateful to Dr. Villamor for pointing out the issue. We are hopeful that the manuscript appearing online can be corrected quickly and can appear in print later in the year, adding to the available global knowledge on the subject.

We shall be happy to provide further information if so required.

Conflict of Interest Statement

The author has no conflicts of interest to declare.

Funding Sources

No funding has been received for this study.

Author Contributions

Zulfiqar A. Bhutta conceptualized, drafted, reviewed and approved the final manuscript as submitted. Zulfiqar A. Bhutta is the guarantor.

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