Nutrients free fulltext oral zinc supplementation for. Zinc supplementation and serum zinc during diarrhea medind. But among children in the poorest countries, zinc deficiency is widespread and can result in higher rates of infectious diseases, including diarrhea. A metaanalysis of the effects of oral zinc in the treatment of acute. Zinc is an important micronutrient for the overall health and development of. Preventive zinc supplementation in developing countries. Introduce zinc with ort as standard treatment for childhood diarrhea on a national scale, with dual emphasis on the public and private sectors. Management of diarrhea, either through oral rehydration salts ors or a appropriate home fluids e. Zinc supplementation seems even more necessary for malnourished children, as they already have a zinc deficiency, which predisposes them to diarrhea and worsens it 50. The only known side effect of zinc use is vomiting, which is rarely reported and is typically attributed to a metallic taste in the zinc.
Zinc supplementation lowers the incidence of diarrhea by 25% and pneumonia by 41%, according to an analysis of studies on children in. One group was fed a zinc supplement diet and another group was used as a control. Zinc deficiency is prevalent in children in developing countries. Zinc deficiency is not uncommon worldwide, but is rare in the us. However, most relevant studies have evaluated the effects of zinc and probiotics using subjective indicators, such as the frequency of bowel movement. Purpose the aim of this study was to analyze the effects of probiotics and zinc supplements on the mean duration and frequency of acute diarrhea in children aged 6. Both zinc and probiotics have been widely reported for the treatment of acute diarrhea. Formative research in preparation for promotion of zinc treatment for childhood diarrhea. Zinc supplementation in malnourished children with. Effects of zinc combined with probiotics on antibiotic.
Who recommends zinc supplementation for children in developing countries who have acute or persistent diarrhea at a dose of 10 mg in infants less than 6 months old and 20 mg in. 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. Rare side effects include fever, sore throat, mouth sores, weakness, and fatigue. There is still a lot more to learn about zinc, but we do know that zinc is an essential part of growth, sexual development, and.
Definition of diarrhea diarrhea is the passage of loose or watery stools at least 3 times in a 24 hour period. The risk of deficiency, however, is enhanced by diarrhea which is associated with variable but sometimes gross increases in zinc losses in the feces. On behalf of usaid, most initiated the effort to prepare. To evaluate the potential benefit of dietary supplementation of a ricelentil khitchri and yogurt diet with 3 mgkgd of elemental zinc as zinc sulfate in hospitalized malnourished children age 636 months with persistent diarrhea for 14 days. Symptoms include slowed growth, low insulin levels, loss of appetite, irritability, generalized hair loss, rough and dry skin, slow wound healing, poor sense of taste and smell, diarrhea, and nausea. Oral zinc sulfate supplements can also cause side effects such as stomach upset, heartburn, and nausea. Zinc treatment is a simple, inexpensive, and critical new tool for treating diarrheal episodes among children in the developing world. 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. Diarrhoea contributes to nutritional deficiencies, reduced resistance to infections and impaired growth and development.
The role of zinc and vitamin a in persistent diarrhea. The effects of zinc supplementation on diarrhea in children with adequate zinc status, such as most children in the united states, are not clear. Zinc is a nutritional supplement mineral usually given as zincs sulfate, zinc acetate, or. Mean duration of diarrhea was 17 hours shorter and mean total cost of treatment was 5% cheaper in the zinc than ors group.
A study tested the hypothesis that daily supplementation of zinc had an effect on the clinical course of acute diarrhea, that is, frequency of stool, stool amount, and duration of acute diarrhea, in. Presence of diarrhea between zinc and placebo at day 1 was not significantly different in acute diarrhea or persistent diarrhea trials. Zinc supplementation in the management of diarrhoea who. The combined recommendation of zinc and ors is a safe, effective and inexpensive diarrhea treatment for children in the developing world. Six clusters of 30 000 people each in haryana, india, were randomly assigned to. Scaling up oral rehydration salts and zinc for the treatment of diarrhoea. Zinc has also been shown to have a similar effect in children with diarrhea caused by infections other than cholera, and is recommended for the treatment of pediatric diarrhea more generally 2. As an adjunctive therapy for diarrhea, zinc supplementation has tremendous potential. Pdf diarrhea and cholera are major health problems. Crosscountry comparison of diarrhea treatment practices and implications for programs. Zinc in acute diarrhea reduces duration of diahheal episode by 25% decrease by about 25% the proportion of episodes lasting more than seven days it is associated with a 30% reduction in stool volume conclusion. Zinc supplements reduce the severity and duration of diarrhea. Zinc is a micronutrient that appears to be of special interest, at least in some communities.
Zinc supplementation in young children with acute diarrhea. Pediatric zinc as treatment for diarrhea pediatric zinc as treatment for diarrhea pdf. The standard ingredient labels for dietary supplements provide the name of the form of zinc in the product e. A vicious cycle of diarrheazinc deficiencydiarrhea has been postulated. Zinc and other micronutrients diarrhoea, diarrhea, dehydration. University of colorado health sciences center hambidge km. Zinc in childhood diarrhea management 36 journal of pharmacy practice and community medicine vol. Zinc supplementation for the treatment of diarrhoea has been shown to decrease the duration and severity of the diarrhoeal episode, diarrhoea hospitalization rates and, in some studies, allcause mortality. Zinc is used by your body in cell production and immune functions. Zincsupplementation is proven to reduce the duration and severity of childhood diarrhea in randomized controlled trials.
To update the available evidence about zinc use for treating diarrhea in children and to assess its effect. At enrollment, 37% of children had plasma zinc levels less than 60. Essential role of vitamin c and zinc in child immunity and. Who recommendations on the management of diarrhoea and. Studies show that zinc dietary supplements help reduce the symptoms and duration of diarrhea in these children, many of whom are zinc deficient or otherwise malnourished. Vibrio cholera, the causative agent of cholera, infects the small intestine, resulting in vomiting, massive watery diarrhea and dehydration. This important micronutrient becomes depleted during diarrhea, but recent studies suggest that replenishing zinc with a10 to 14day course of treatment can reduce the duration and severity of diarrheal episodes and may also prevent future. The world health organization and unicef now recommend shortterm zinc supplementation 20 mg of zinc per day, or 10 mg for infants under 6 months, for 1014 days to treat acute childhood diarrhea. Reduced water and electrolyte absorption is also due to zinc deficiency. Trials have included more than 8,500 children who participated in efficacy trials in both the placebo and zinc study arms. Diarrhea remains a major public health problem, especially in children in developing countries, with approximately. There are two simple and effective treatments for the clinical management of acute diarrhoea.
Zinc supplementation in acute diarrhea is acceptable, does not interfere with oral rehydration, and reduces the use of other medications. Zinc supplementation as adjunct therapy in diarrhea has been. Although it is well established that diarrhea leads to excess zinc losses, until recently, little evidence was available to show that zinc deficiency increases the risk of developing acute or persistent diarrhea. Zinc and other micronutrients can become depleted through diarrhea, and zincdeficient and otherwise malnourished children are more prone to diarrhea, too. Weight loss, problems with wound healing, decreased ability to taste food, and lower alertness levels can also occur. There was a significant reduction of 21% in the number of days with watery stools in the zincsupplement group. Journal of pediatric gastroenterology and nutrition. Many of these symptoms can be signs of problems other than zinc deficiency. Zinc deficiency has been documented in otherwise normal children. Research article open access zinc treatment ameliorates. Acute diarrhea, oral rehydration solutionssalts, zinc salts. Zinc supplementation for treating diarrhea in children. Ors treatment amongst children with diarrhea zinc supplementation for children with diarrhea one protection indicator exclusive breastfeeding in first 6 months country selection the countries with the largest number of pneumonia and diarrhea deaths in children under5 were analyzed in this progress report. Vibrio cholera, the causative agent of cholera, infects the small intestine, resulting in.
Pdf mechanisms of action of zinc in acute diarrhea researchgate. Diarrhoea treatment guidelines i preface the need for guidance on how to implement the new who unicef recommendations for the use of ors and zinc supplementation in the clinical management of diarrhoea was articulated at a meeting at johns hopkins university in june, 2004. The purpose of this work was to evaluate whether education about zinc supplements and provision of zinc supplements to caregivers is effective in the treatment of acute diarrhea and whether this strategy adversely affects the use of oral rehydration salts. Zinc has an important role in recovery from the disease. Zinc and diarrhea k michael hambidge department of pediatrics. Zinc is a common ingredient in many overthecounter products, including throat lozenges, lotions, and nasal sprays. Pdf for over a decade, the importance of zinc in the treatment of acute diarrhea has been recognized. Diarrhoea remains a leading cause of death globally among children under five years of age. Use of highquality zinc products easily avert this side effect.
The former reduces the severity and duration of diarrhea, while the latter relieves the symptoms 2, 3. Dietary zinc oxide in weaned pigs effects on performance. The improved treatment of acute diarrhea in children during the past 35 years has reduced its morbidity and mortality substantially. Uses, side effects, interactions, dosage, and warning. Severe diarrhoea leads to fluid loss, and may be lifethreatening. Production of zinc tablets and zinc oral solutions.
Zinc deficiency also causes hair loss, diarrhea, eye and skin sores, and loss of appetite. Role of zinc in pediatric diarrhea pubmed central pmc. However, despite this evidence, its efficacy to reduce diarrhea morbidity in adults remains unknown. Zinc deficiency is very common in developing countries and is more pronounced during an episode of diarrhea.
Introducing improved treatment of childhood diarrhea with. However, it is the consistency of the stools rather than the num. Diarrhea is consistently found in children with severe zinc deficiency, 11,12 as well as in animals with zinc depletion. Zinc reduces pneumonia, diarrhea in children in developing. Zinc supplementation reduced cost and duration of acute. As an adjunct in the management of acute diarrhea together with reduced osmolarity ors. Who zinc supplementation in the management of diarrhoea. Oral zinc supplementation for the treatment of acute diarrhea in children.
Diarrhea is the second leading cause of death among children under five worldwide. To prevent diarrhea in infants, pregnant women have used 15 mg of zinc, with or without 60 mg of iron and 250 mcg of folic acid, starting 10. Zinc supplementation in the management of diarrhoea. Elemental zinc supplementation for 1014 days is recommended, with increased fluids and continued feeding, for all hivinfected and exposed children with diarrhoea, at 10 mgday for infants 6 months. Zinc supplementation to reduce diarrhea rates in adults in. The uptake and distribution of zinc in tissues and the effects of 2500 ppm dietary zinc oxide on health, faecal microflora, and the functions of circulating neutrophils were evaluated in weaned pigs. Zinc is an important micronutrient for the overall health and development of infants and young children.
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