Department of Community Medicine, Maulana Azad Medical College, New Delhi, India.
Pediatrics. 2013 Jul;132(1):e46-52. doi: 10.1542/peds.2012-2980. Epub 2013 Jun 3.
Zinc supplementation during diarrhea substantially reduces the incidence and severity of diarrhea. However, the effect of short-course zinc prophylaxis has been observed only in children >12 months of age. Because the incidence of diarrhea is comparatively high in children aged 6 to 11 months, we assessed the prophylactic effect of zinc on incidence and duration of diarrhea in this age group.
In this randomized, double-blind, placebo-controlled trial, we enrolled infants aged 6 to 11 months from an urban resettlement colony in Delhi, India, between January 1, 2011, and January 15, 2012. We randomly assigned 272 infants to receive either 20 mg of zinc or a placebo suspension orally every day for 2 weeks. The primary outcome was the incidence of diarrhea per child-year. All analyses were done by intention-to-treat.
A total of 134 infants in the zinc and 124 in the placebo groups were assessed for the incidence of diarrhea. There was a 39% reduction (crude incident rate ratio [IRR] 0.61, 95% confidence interval [CI] 0.53-0.71) in episodes of diarrhea, 39% (adjusted IRR 0.61, 95% CI 0.54-0.69) in the total number of days that a child suffered from diarrhea, and reduction of 36% in duration per episode of diarrhea (IRR 0.64, 95% CI 0.56-0.74) during the 5 months of follow-up.
Short-course prophylactic zinc supplementation for 2 weeks may reduce diarrhea morbidity in infants of 6 to 11 months for up to 5 months, in populations with high prevalence of wasting and stunting.
腹泻期间补锌可显著降低腹泻发生率和严重程度。然而，仅在 12 个月以上儿童中观察到短期补锌预防作用。由于 6 至 11 个月儿童腹泻发生率相对较高，我们评估了该年龄段儿童补锌对腹泻发生率和持续时间的预防作用。
在这项随机、双盲、安慰剂对照试验中，我们于 2011 年 1 月 1 日至 2012 年 1 月 15 日期间从印度德里的一个城市移民区招募了 6 至 11 个月大的婴儿。我们将 272 名婴儿随机分为两组，分别每天口服 20 毫克锌或安慰剂混悬液，持续 2 周。主要结局是每个儿童年腹泻发生率。所有分析均按意向治疗进行。
共有 134 名锌组和 124 名安慰剂组婴儿评估腹泻发生率。腹泻发作次数减少 39%（粗发病率比[IRR]0.61，95%置信区间[CI]0.53-0.71），腹泻天数减少 39%（调整后 IRR 0.61，95% CI 0.54-0.69），每次腹泻持续时间减少 36%（IRR 0.64，95% CI 0.56-0.74），随访 5 个月。
在高消瘦和生长迟缓流行的人群中，2 周的短期补锌预防可在 5 个月内降低 6 至 11 个月婴儿腹泻发病率。
