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

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 trial

SETTING

International Centre for Diarrhoeal Disease Research, Bangladesh.

SUBJECTS

Sixty-five children aged 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 two 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 0.6, 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 3.0d, 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.