Naheed Aliya, Walker Fischer Christa L, Mondal Dinesh, Ahmed Saifuddin, Arifeen Shams El, Yunus Mohammad, Black Robert E, Baqui Abdullah H
International Centre for Diarrhoeal Disease Research, Mohakhali, Bangladesh.
J Pediatr Gastroenterol Nutr. 2009 Jan;48(1):89-93. doi: 10.1097/MPG.0b013e31817f0182.
We assessed the effect of zinc for the treatment of diarrhoea implemented at the community level on physical growth among children 6 to 35 months of age.
The service areas of 30 community health workers in the Matlab field site of International Centre for Diarrhoeal Disease Research, Bangladesh, were randomly allocated to the intervention or comparison study arm. Between November 1998 and October 2000, caretakers of 3- to 59-month-old children with diarrhoea in both intervention and comparison areas were offered oral rehydration solution and feeding advice, and severe episodes were referred for facility-based care. The caretakers of the children in the intervention area were additionally offered 20 mg/day elemental zinc for 14 days as adjunct treatment for each diarrhoea episode. Weight and length of children who were 6 to 11 months of age at the beginning of the study were measured every 2 months for 2 years. Rates of length and weight gains were compared between children living in intervention and control arms using a latent growth model.
Characteristics of children living in control and intervention areas were similar, except that more children living in intervention areas were underweight at baseline (44 vs 35%; P = 0.02). Children living in intervention clusters gained slightly more weight and length than children in the control clusters (86.4 g/year and 2.8 mm/year, respectively).
The therapeutic use of zinc along with oral rehydration solution for community-based diarrhoea management may have a small positive benefit on the rates of growth among children younger than 3 years of age.
我们评估了在社区层面实施的锌治疗腹泻措施对6至35个月大儿童身体生长的影响。
在孟加拉国腹泻病研究国际中心的马特实验室现场,将30名社区卫生工作者的服务区域随机分配到干预组或对照组。1998年11月至2000年10月期间,为干预组和对照组中3至59个月大腹泻儿童的看护人提供口服补液盐和喂养建议,严重病例转诊至医疗机构治疗。干预组儿童的看护人在每次腹泻发作时还额外给予14天每天20毫克元素锌作为辅助治疗。对研究开始时6至11个月大的儿童进行为期2年的随访,每2个月测量一次体重和身长。使用潜在生长模型比较干预组和对照组儿童的身长和体重增长速度。
对照组和干预组儿童的特征相似,但干预组中基线时体重不足的儿童更多(44%对35%;P = 0.02)。干预组儿童的体重和身长增长略高于对照组儿童(分别为每年86.4克和每年2.8毫米)。
在社区腹泻管理中,锌与口服补液盐联合治疗可能对3岁以下儿童的生长速度有轻微的积极益处。