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

Abstract

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