Oral Zinc Supplementation for the Treatment of Acute Diarrhea in Children: A Systematic Review and Meta-Analysis

Abstract

Evidence supporting the impact of therapeutic zinc supplementation on the duration and severity of diarrhea among children under five is largely derived from studies conducted in South Asia. China experiences a substantial portion of the global burden of diarrhea, but the impact of zinc treatment among children under five has not been well documented by previously published systematic reviews on the topic. We therefore conducted a systematic literature review, which included an exhaustive search of the Chinese literature, in an effort to update previously published estimates of the effect of therapeutic zinc. We conducted systematic literature searches in various databases, including the China National Knowledge Infrastructure (CNKI), and abstracted relevant data from studies meeting our inclusion and exclusion criteria. We used STATA 12.0 to pool select outcomes and to generate estimates of percentage difference and relative risk comparing outcomes between zinc and control groups. We identified 89 Chinese and 15 non-Chinese studies for the review, including studies in 10 countries from all WHO geographic regions, and analyzed a total of 18,822 diarrhea cases (9469 zinc and 9353 control). None of the included Chinese studies had previously been included in published pooled effect estimates. Chinese and non-Chinese studies reported the effect of therapeutic zinc supplementation on decreased episode duration, stool output, stool frequency, hospitalization duration and proportion of episodes lasting beyond three and seven days. Pooling Chinese and non-Chinese studies yielded an overall 26% (95% CI: 20%−32%) reduction in the estimated relative risk of diarrhea lasting beyond three days among zinc-treated children. Studies conducted in and outside China report reductions in morbidity as a result of oral therapeutic zinc supplementation for acute diarrhea among children under five years of age. The WHO recommendation for zinc treatment of diarrhea episodes should be supported in all low- and middle-income countries.

Zinc deficiency alters host response and pathogen virulence in a mouse model of enteroaggregativeescherichia coli-induced diarrhea

“…The WHO supports the use of zinc supplementation in reducing childhood diarrhea in low and middle income countries. 48 Additionally, a Cochrane Review has recommended the use of zinc in enhancing immune response to the common cold. 17 In the current study, we show the combined effects of dietary zinc on both increasing the host immunity as well as decreasing the pathogenicity of EAEC.…”

Peranan Zinc Pada Penanganan Kasus Penyakit Diare Yang Dialami Bayi Maupun Balita

“…Rekomendasi ini didasarkan pada bukti biologis dan epidemiologi yang kuat menunjukkan bahwa pemberian suplemen zinc secara signifikan dapat mengurangi durasi, volume tinja dan frekuensi dari diare (10). Suplemen zinc merupakan solusi rehidrasi oral untuk pengobatan semua episode diare pada anak-anak kurang dari 5 tahun selain oralit (11).…”

“…Systemic review yang dilakukan oleh Lamberti, et al (2013) menyatakan studi di Cina dan non-Cina melaporkan bahwa efek pemberian suplementasi terapi zinc menurunkan lamanya diare, keluaran feses, frekuensi tinja, durasi rawat inap dan proporsi episode yang berlangsung lebih dari tiga dan tujuh hari (11). Penelitian yang dilakukan oleh Asuquo (2013) menyatakan adanya efektivitas suplemen zinc dalam menghentikan jalannya penyakit diare pada anak-anak usia 0 sampai 59 bulan.…”

Importance of zinc for the human body in the aspect of zinc supplementation

“…Dodatkowo przyczynia się do redukcji ryzyka wystąpienia infekcji układu oddechowego i przyspieszenia wzrostu niedożywio-nych dzieci. Wynikiem wszystkich wyżej wymienionych efektów jest skrócenie czasu hospitalizacji i zmniejszenie śmiertelności w przebiegu ostrych biegunek [49,50,51]. Istotne są również korzyści płynące z suplementacji cynku u dzieci w wieku szkolnym.…”