Zinc Supplementation in the Case of Diarrheal Disease

Pakistan BioMedical Journal, 2021

According to World Health Organization (WHO) approximately four million children less than 5 years of age in Asia, Africa, and Latin America die annually from diarrhea; and 80% of these deaths occur in the first year of life. Objective: To see how a zinc supplement influences the severity of acute diarrhea in children under the age of five. Methods: In current study, we analyze the effect of zinc on diarrheal patients. Zinc was randomly assigned to diarrheal patients in different concentration 5 mg, 10 mg, 15 mg and 20 mg. There were two groups in our study, treatment and control group. Results: The results are presented in the form of descriptive and inferential statistics. In T1 (Treatment Group) number of Diarrhea patients < 1 Year of age were 16, 2-4 years of age were 45, 4-5 years of age and maximum no of patients in T1 < 2 year of age were 57. Number of male patients were 84 while female patients were 67 in T1.In T2 (Control Group) number of male patients were 92 while f...

Bangladesh Journal of Medical Science

Background: Nearly 1.7 million children suffer from diarrhoea and around 760,000 die each year. The high prevalence of diarrhoea in the developing countries is closely related to lack of safe drinking water, inadequate sanitation and hygiene, and poor health and nutritional status. These environmental conditions facilitate the spread of infectious disease easily. The great morbidity and mortality of this preventable and treatable disease raise concern on how to save children from this fatal disease by improving management of diarrhoea. Several studies suggest that zinc deficiency contribute towards high morbidity and mortality in diarrhoea. Further, there is an area of uncertainty regarding how significant zinc supplementation will help to reduce the duration and severity of diarrhoea in children compared to the diarrhoea management without zinc? Objective: To critically analyse the current evidences of zinc supplementation in diarrhoea. Data Sources: Keywords searching through MEDL...

Clinical Nutrition, 2015

Background & aims: It is estimated that zinc deficiency is responsible for 4.4% of childhood deaths in Africa, Asia, and Latin America. This review examines the impact of zinc supplementation, administered prophylactically or therapeutically, on diarrhoea. Methods: Relevant published articles were identified through systematic searches of electronic databases. Bibliographies of retrieved articles were examined. Results: A total of 38 studies were included in this review, 29 studies examined the effect of prophylactic zinc and nine studies examined the effects of therapeutic use of zinc for treatment of diarrhoea in children under five years. Conclusion: Prophylactic zinc has been shown to be effective in decreasing both prevalence and incidence of diarrhoea, reducing respiratory infections and improving growth in children with impaired nutritional status. There is less conclusive evidence of reduction in diarrhoea duration or diarrhoea severity. While prophylactic zinc decreases mortality due to diarrhoea and pneumonia, it has not been shown to affect overall mortality. Therapeutic use of zinc for the treatment of diarrhoea in children has been shown to reduce diarrhoea incidence, stool frequency and diarrhoea duration as well as respiratory infections in zinc deficient children. However, stool output is only reduced in children with cholera. Less conclusive evidence exists for therapeutic zinc reducing mortality due to diarrhoea and respiratory infections. Specific definitions of diarrhoea severity, respiratory infection in further studies as well as examination of prophylactic zinc effectiveness in diarrhoea duration and severity effectiveness of therapeutic zinc in reducing mortality due to diarrhoea and respiratory infections are warranted.

PEDIATRICS, 2002

Intervention trials have shown that zinc is efficacious in treating acute diarrhea in children of developing countries. In a randomized, placebo-controlled trial, we assessed the effectiveness and efficacy of giving 3 Recommended Daily Allowances of elemental zinc to 6-to 35-month-old children with acute diarrhea. Methods. Seventeen hundred ninety-two cases of acute diarrhea in Nepalese children were randomized to 4 study groups. Three groups were blinded and the children supplemented daily by field workers with placebo syrup, zinc syrup, or zinc syrup and a massive dose of vitamin A at enrollment. The fourth group was open and the caretaker gave the children zinc syrup daily. Daywise information on morbidity was obtained by household visits every fifth day. Results. The relative hazards for termination of diarrhea were 26% (95% confidence interval [CI]: 8%, 46%), 21% (95% CI: 4%, 38%), and 19% (95% CI: 2%, 40%) higher in the zinc, zinc-vitamin A, and zinc-caretaker groups, respectively, than in the placebo group. The relative risks of prolonged diarrhea (duration >7 days) in these groups were 0.57 (95% CI: 0.38, 0.86), 0.53 (95% CI: 0.35, 0.81), and 0.55 (0.37, 0.84); zinc accordingly reduced the risk of prolonged diarrhea with 43% to 47%. Five percent and 5.1% of all syrup administrations were followed by regurgitation in the zinc and zinc-vitamin A group, respectively, whereas this occurred after only 1.3% of placebo administrations. Vomiting during diarrhea was also more common in children receiving zinc. Conclusions. Three Recommended Daily Allowances of zinc given daily by caretakers or by field workers substantially reduced the duration of diarrhea. The effect of zinc was not dependent on or enhanced by concomitant vitamin A administration. Pediatrics 2002;109:898-903; zinc, vitamin A, acute diarrhea, young children, randomized placebo controlled trial, effectiveness, Nepal, treatment.

2010

Intervention trials have shown that zinc is efficacious in treating acute diarrhea in children of developing countries. In a randomized, placebo-controlled trial, we assessed the effectiveness and efficacy of giving 3 Recommended Daily Allowances of elemental zinc to 6-to 35-month-old children with acute diarrhea. Methods. Seventeen hundred ninety-two cases of acute diarrhea in Nepalese children were randomized to 4 study groups. Three groups were blinded and the children supplemented daily by field workers with placebo syrup, zinc syrup, or zinc syrup and a massive dose of vitamin A at enrollment. The fourth group was open and the caretaker gave the children zinc syrup daily. Daywise information on morbidity was obtained by household visits every fifth day. Results. The relative hazards for termination of diarrhea were 26% (95% confidence interval [CI]: 8%, 46%), 21% (95% CI: 4%, 38%), and 19% (95% CI: 2%, 40%) higher in the zinc, zinc-vitamin A, and zinc-caretaker groups, respectively, than in the placebo group. The relative risks of prolonged diarrhea (duration >7 days) in these groups were 0.57 (95% CI: 0.38, 0.86), 0.53 (95% CI: 0.35, 0.81), and 0.55 (0.37, 0.84); zinc accordingly reduced the risk of prolonged diarrhea with 43% to 47%. Five percent and 5.1% of all syrup administrations were followed by regurgitation in the zinc and zinc-vitamin A group, respectively, whereas this occurred after only 1.3% of placebo administrations. Vomiting during diarrhea was also more common in children receiving zinc. Conclusions. Three Recommended Daily Allowances of zinc given daily by caretakers or by field workers substantially reduced the duration of diarrhea. The effect of zinc was not dependent on or enhanced by concomitant vitamin A administration. Pediatrics 2002;109:898-903; zinc, vitamin A, acute diarrhea, young children, randomized placebo controlled trial, effectiveness, Nepal, treatment.

Sultan Qaboos University medical journal, 2007

To study the impact of zinc administration on the morbidity and mortality attributed to diarrhoea among children less than 5 years old. The study design was a randomized double blinded controlled clinical trial, held at Elsabeen Hospital for Maternity and Childhood, Sana'a, Yemen. The study was conducted during the period September 2005 to October 2006 on 180 children less than 5 years old with acute diarrhoeal episodes. They were randomly allocated to two groups; one of them received a placebo and the other received zinc acetate syrup for 14 days. Both groups were followed up for 2 months. ZINC WAS ABLE TO DECREASE THE MEAN NUMBER OF DIARRHOEAL EPISODES: 1.39 in the intervention group versus 2.59 in the control group. It also reduced the mean frequency of stools per day in each attack (3.57 in the intervention group versus 5.47 in the control group) and the volume of stool in each attack during the follow-up period. Moreover, zinc was significantly more palatable. We can conclu...

The American journal of clinical nutrition, 2005

Recent studies reported that zinc significantly reduced the duration and volume of acute watery diarrhea in children aged > or = 4 mo, but there were no data specifically on infants aged < 6 mo. This study investigated the effect of zinc on the duration of illness and the stool quantity in acute watery diarrhea of infants aged 1-6 mo by comparing a 20 mg Zn/d dose with a 5 mg Zn/d dose. Infants hospitalized with at least some dehydration (by World Health Organization classification) were enrolled in a double-blind, randomized, placebo-controlled trial. Infants were randomly assigned to receive 20 mg Zn (acetate)/d, 5 mg Zn/d, or placebo for the duration of illness. Two hundred seventy-five infants were enrolled between 20 September 1998 and 18 December 2000. Neither diarrhea duration nor mean stool volume differed between groups. There were no significant differences in fluid intake, the need for unscheduled intravenous fluid, weight gain, or vomiting rates between the groups....

Journal of Evolution of medical and Dental Sciences, 2015

BACKGROUND: Diarrhoea is one of the leading causes of morbidity and mortality affecting children in developing countries. We studied the efficacy of zinc therapy in reducing the duration of diarrhoea. MATERIALS AND METHODS: A double-blinded randomized control study was done in 100 children between age groups 1 month to 5 years having acute diarrhoea. These children were randomly divided into 2 groups. Group 1 received oral supplementation of 20mg zinc and ORS from day one of treatment while group 2 received only ORS therapy. Children who received zinc or antibiotics prior to the study were excluded. Clinical profile of children like age, gender, nutritional status and dehydration level was have been taken into consideration. The outcome of the study was assessed by comparing the mean number of watery stools of both the groups during the course of therapy. RESULTS: Out of 100 children based in the study 50 children in group 1 who received oral zinc supplementation showed a 36% reduction in duration of diarrhoea (6.22 days vs. 8.26 days). CONCLUSION: Zinc supplementation help reduce the duration of acute diarrhoea.

Gastroenterology Research, 2009

Background: To test the hypothesis that daily supplementation of zinc has any effect on clinical course of acute diarrhea, i.e. frequency of stool, on stool amount and duration of acute diarrhea. Methods: In a randomized double blind placebo controlled trial, 117 children aged 6 months to 59 months in a medical college hospital, with acute diarrhea of less than 14 days were assigned by permuted block design 1:1 to receive intervention of zinc supplemented syrup (n = 60) or placebo syrup (n = 57). Results: Baseline characteristics were similar in both the groups. Mean age in zinc supplemented group was 22.14 ± 16.68 months and in placebo group 25.66 ± 17.02 months. Reduction in stool frequency per day was found 62% in zinc supplemented group and 26% reduction was found in placebo supplemented group with obvious difference of 36% between these two groups from day 1 to day 3 and day 5, which was found statistically highly significant. Similarly, significant difference was observed for reduction in amount of stool per day from day 1 to day 3 and day 5 with obvious difference of 45% between the study groups. Conclusions: Oral zinc administration in acute diarrhea reduces the frequency of diarrhea and output of stool by changing the natural course of acute diarrheal disease, causes early normalization of stool consistency, early recovery and decreases total duration of hospital stay. Zinc supplementation is simple, acceptable and affordable strategy which should be considered in management of acute diarrhea.

Revista Panamericana de Salud Pública, 2013

Rev Panam Salud Publica 33(5), 2013 Galvao TF, Thees MFRS, Pontes RF, Silva MT, Pereira MG. Zinc supplementation for treating diarrhea in children: a systematic review and meta-analysis. Rev Panam Salud Publica. 2013;33(5):370-7.