Impact of zinc supplementation on subsequent growth and morbidity in Bangladeshi children with acute diarrhoea

• Published in: European journal of clinical nutrition 1999-07, Vol.53 (7), p.529-534
• Main Authors: Roy, S.K, Tomkins, A.M, Haider, R, Behren, R.H, Akramuzzaman, S.M, Mahalanabis, D, Fuchs, G.J
• Format: Article
• Language: English
• Subjects: Acute Disease; Bangladesh; Biological and medical sciences; Body weight; Body weight gain; Child, Preschool; Children; Children & youth; Diarrhea; Diarrhea - complications; Diarrhea - drug therapy; Diarrhea - physiopathology; dietary mineral supplements; Dietary Supplements; dosage; Double-Blind Method; Female; growth; Growth - drug effects; height; Humans; incidence; Infant; infants; infection; Male; Malnutrition; Medical sciences; Metabolic diseases; Morbidity; Nutrition Disorders - complications; Nutrition Disorders - physiopathology; Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...); Physical growth; preschool children; Respiratory tract; Respiratory tract diseases; Respiratory Tract Infections - etiology; Respiratory Tract Infections - prevention & control; Supplements; Syrup; Underweight; vitamin supplements; Vitamins; Weight Gain - drug effects; Weight reduction; Zinc; Zinc - administration & dosage; Zinc - therapeutic use
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1600734

Objective: To assess the impact of zinc supplementation during acute diarrhoea on subsequent growth and morbidity in malnourished young children. Design: Double blind randomized controlled clinical trail Setting: International Centre for Diarrhoeal Disease Research, Bangladesh. Subjects: Sixty-five children 3-24 months with acute diarrhoea for less than 3 d. Intervention: Either elemental zinc (20 mg/d) in a multivitamin syrup or multivitamin syrup alone divided in three divided daily doses for a period of eight weeks. Children were followed up weekly at home to assess subsequent growth and morbidity for a period of eight weeks. Main outcome measures: Gain in length and body weight and reduction in diarrhoea and respiratory tract infection. Results: During the follow-up, zinc supplemented children showed significantly greater cumulative length gain (18.9 mm vs 14.5 mm, P < 0.03) and comparable body weight gain than the children of the control group. Subsequent length gain was not correlated with initial height in the zinc-supplemented group (r = -0.13), P = 0.5), but was significantly correlated in the control group (r = -0.6, P < 0.0007). Zinc-supplemented and stunted children ( < or = 90% length for age n = 18) experienced significantly fewer episodes of diarrhoea (0.07 vs 0.06, P < 0.05) and respiratory illness (1.0 vs 2.4, P < 0.01) compared to the control group. The underweight children (< or = 71% weight/age n = 38) receiving zinc-supplementation also had fewer episodes of diarrhoea (0.4 vs 1.0, P < 0.04) and shorter duration of diarrhoeal episodes (1.0 vs 3.0 d, P < 0.04) compared to their counterparts in the control group. Conclusion: These results suggest that a short course of zinc supplementation to malnourished children during acute diarrhoea reduces growth-faltering and diarrhoeal and respiratory morbidity during subsequent two months.