ZINC SUPPLEMENTATION IN DIARRHEA
Impact of zinc supplementation in malnourished children with acute watery diarrhea.
Journal of Tropical Pediatrics 2000 46(5):259-263.
To evaluate the efficacy of oral supplementation of Zinc as an adjunct therapy to oral rehydration solution. (ORS).
A double-blind, randomized, controlled clinical trial was conducted on 80 malnourished children with acute dehydrating diarrhea. After decoding it was observed that 44 children received zinc sulphate (177 mg/kg/day in three divided doses equivalent to 40 mg elemental zinc) in a syrup form and 36 children received only syrup placebo. Clinical parameters and microbiological findings of stool samples were comparable in the two groups at the time of enrolment.
All the children (100 per cent) in the zinc supplemented group and 32 (89 per cent) children in the placebo group recovered within 5 days of hospitalization (p=0.04). The zinc supplemented group had a significantly shorter duration of diarrhoea (70.4 + 10.0 vs 103.4 + 17.1; p=0.0001), passed less liquid stool (1.5 + 0.7 vs. 2.4 + 0.7 kg; p=0.0001), consumed less oral rehydration solution (2.5 + 1.0 vs. 3.6 + 0.8 litre; p=0.0001) and other liquids (867.0 + 466.1 vs. 1354.7 + 675.6 ml; p=0.0001) as compared to the placebo group.
Above findings suggest that Zinc supplementation as an adjunct therapy to ORS has beneficial effects on the clinical course of dehydrating acute diarrhea.
Zinc supplementation reduced cost and duration of acute diarrhea in children.
J Clin Epidemiol. 2007 Jun;60(6):560-566. Epub 2006 Dec 11
To determine whether Zinc with oral rehydration solution (ORS) is more cost effective than ORS alone in treatment of acute diarrhea.
Study Design And Setting:
Cost-effectiveness analysis among patients consulting the emergency room of a government institution.
Cost of treatment and outcome of participants of a randomized trial of zinc+ORS vs. ORS alone for acute diarrhea were investigated. Included were subjects 2-59 months with diarrhea less than 7 days and no dehydration. The direct medical, nonmedical and indirect costs were obtained, using the societal perspective. The incremental cost-effectiveness ratio (ICER) was calculated.
60 patients were given zinc_ORS and 57 were given ORS alone. Mean duration of diarrhea was 17 hours shorter and mean total cost of treatment was 5% cheaper in the zinc than ORS grop.
Use of zinc with ORS reduced the total cost and duration of acute diarrhoea.
Zinc supplementation and serum zinc during diarrhea
Indian J Pediatr. 2006 Jun;73(6):493-7
Zinc deficiency is very common in developing countries and is more pronounced during an episode of diarrhea. Supplementation with zinc improves diarrhea and might correct zinc deficiency in both the short and longer term.
Serum zinc was low in 44% of healthy children at the first blood draw. Compared to healthy controls, serum zinc was 3.1 mmol/L higher among children with diarrhoea who were supplemented with zinc at first blood draw and 1.3 mmol/L higher 3 weeks later.
A nested study was conducted within a cluster randomized treatment trial. 50 children with diarrhoea living in the zinc treated clusters, 50 children with diarrhoea living in control clusters, and 50 healthy children living in the control clusters were enrolled. Serum zinc at the start of the diarrhoea episode was assessed (1-3 days after supplementation began in zinc treated children), and again one week after the diarrhoea ended and supplementation ceased. Baseline characteristics and serum zinc concentration were assessed.
Zinc supplementation enhances serum zinc concentration when given as a treatment for diarrhoea and helps children maintain a more adequate zinc status during the convalescent period.
Zinc in the treatment of acute diarrhea: current status and assessment
Gastroenterology 2006 Jun;130(7):2201-5
To review the role of ORS in the treatment of acute diarrhea with particular attention to recent efforts to develop improved oral rehydration solution formulations.
One promising approach is the administration of Zinc (Zn). Basedon its beneficial effects in infections, including pneumonia, Zn has been shown to be effective in the treatment of acute diarrhea in several randomized controlled trials including subsequent meta-analyses.
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