Efficacy and Effectiveness of Zinc Therapy in the Treatment of Acute Diarrhoea Among Children

Abstract

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. KEYWORDS: Zinc, Diarrhoea. INTRODUCTION:Diarrhoeal disease is a major cause of childhood morbidity and mortality affecting millions of children worldwide. (1,2) It is estimated that more than 3 million deaths in developing countries each year is caused by diarrhoeal disease and contribute substantially to malnutrition in surviving children. (2) In accordance with the recommendations of WHO and UNICEF over the past 3 decades children of all ages including infants with acute diarrhoea of any etiology have been treated with standard oral rehydrating salt (ORS) solution. (3) Due to proven efficacy, safety and low cost, standard ORS has been widely used. Along with continued feeding, ORS has helped to bring about a decline in the fatality rate of acute dehydrating diarrhoea in children in developing countries (3). However with the use of ORS there is no reduction of stool volume, diarrhoeal duration and frequency of loose stools raising a practical problem of its acceptance and compliance. (4) Studies have reported that daily loss of zinc in the intestinal fluid during acute diarrhoea is as high as 159 mic/kg/day compared to 47 mic/kg/day in control. (5) A simple and sensitive measuring tool for zinc status is lacking, It can however be assumed that because of low bioavailability of zinc from cereal based diet (6) subclinical zinc deficiency is common in developing countries. Few children with acute diarrhoea also have lowered immunity as manifested by the absence of a cell mediated response to common antigen applied to skin. Micronutrient deficiency is the most likely explanation for this phenomenon. (7) Zinc is important for growth of intestinal mucosa and improves the transport of water and electrolytes (8) across the intestinal mucosa. Zinc also is essential in growth, protein synthesis, epithelial repair and synthesis of RNA and DNA. (9)

Comparison Of Clinical Efficacy Of Combined Versus Monotherapy Of Oral Zinc And Probiotic In Pediatric Acute Diarrhoea At Benazir Bhutto Shaheed Teaching Hospital, Abbottabad

“…They found increase in serum zinc level after zinc treatment in diarrhoeal children. Similar findings have been reported in other studies [14][15][16][17] . Further, Habib et al 10 showed that zinc decreases the diarrhoeal episodes with faster recovery rates in any available preparation, however better results have been seen with suspension form in terms of patients' compliance.…”

Evaluating efficacy of oral zinc as adjuvant therapy in acute diarrhea in children.

“…Now the WHO and UNICEF recommended 10-14 days zinc therapy with ORS for the acute diarrhea in children. [7][8][9] Many studies had reported efficacy of Zn adjuvant therapy in children under 5 years. [7][8][9][10] However, guidelines are lacking on the use of Zn in acute diarrhea.…”

“…[7][8][9] Many studies had reported efficacy of Zn adjuvant therapy in children under 5 years. [7][8][9][10] However, guidelines are lacking on the use of Zn in acute diarrhea. The present study was planned to evaluate the effects of Zn adjuvant therapy in children in terms of improvement in stool frequency and volume and duration of diarrhea at our tertiary care hospital.…”