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Home All Specialties Infectious Disease

Short-term zinc prophylaxis decreases infant diarrhea morbidity

byAndrew Bishara
June 3, 2013
in Infectious Disease, Pediatrics
Reading Time: 4 mins read
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Image: PD

1. Short-term zinc prophylaxis in infants is associated with decreased morbidity from diarrheal episodes. 

2. In those infants receiving zinc supplementation, there was a decrease in incidence and duration of diarrheal episodes, and total number of days suffering from diarrhea during the 5 months following supplementation.

 Evidence Rating Level: 1 (Excellent)

Study Rundown: Deficiency of the mineral cofactor, zinc, is associated with upregulation of intestinal secretory factors. Previous studies of supplementation in children over 1 year of age have indicated that zinc treatment may contribute to reductions in concerning diarrhea-associated morbidity. This community-based randomized control trial, conducted in a migrant population in India, examined short-term prophylactic zinc supplementation in infants 6 – 11 months of age. Prophylactic supplementation for 2 weeks was followed by monitoring of symptoms for 5 months. In comparison to controls, supplemented infants had decreased incidence of diarrhea, reduced diarrheal episode duration, and fewer total days spent suffering from diarrhea. While no serum zinc measurements were taken prior to supplementation, the study population had a high level of stunted growth, which served as a proxy for zinc deficiency. Although this study was limited by its lack of serum zinc measurements, the observed reduction in diarrheal morbidity following short-term supplementation suggests a relatively cost-efficient method to address this significant source of morbidity and mortality worldwide.

Click to read the study published today in Pediatrics

Relevant Reading: Zinc Deficiency, Infectious Disease, and Mortality in the Developing World

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“This trial is among the first studies where the effect of short course zinc prophylaxis has been exclusively studied in a large sample of normal infants belonging to 6-11 months of age. It showed that short course prophylactic zinc supplementation in normal infants of 6-11 months significantly reduces diarrhea morbidity even after five months of follow up. The results of this study have important cost and operational implications. Short-course prophylaxis of zinc in an adequate dose might be more feasible than continuous therapies if zinc needs to be introduced as a community based prophylactic intervention, which will cover all children. This will reduce the overall incidence of diarrhea in the community compared to administration of zinc only to a small proportion of children who seek treatment. However, further trials are required in similar populations both in developed and developing countries to make available [valid] evidence for policy makers.” 

In-Depth [randomized control trial]: 272 infants, aged 6-11 months, were recruited from a predominantly migrant population in 2 resettlement colonies in India. Serum zinc levels were not measured at baseline, but a previous census of this area suggested high prevalence of zinc deficiency. Each infant was randomly assigned to receive either 20 mg of zinc or placebo suspension orally, every day for 2 weeks. Follow-up took place every other week for 5 months following completion of supplementation. A significant, 39% reduction in incidence of diarrheal episodes was noted in supplemented infants compared to those who received placebo (329 vs. 500; 95% CI 0.53-0.71). Additionally, there was a significant, 36% reduction in duration per episode of diarrhea, with 39% fewer total days in supplemented infants. This double-blinded trial was conducted in 2 phases over a year to eliminate seasonal variations; there were no significant differences between the phases.

By Neha Joshi and Leah H. Carr

More from this author: Childhood ADHD significantly associated with adult obesity, Even low lead levels associated with decreased reading ability, Immunotherapy shows efficacy for pediatric allergic asthma and rhinitis New pediatric GERD management guidelines released, Quality improvement methods increase adherence to pediatric pneumonia treatment guidelines, Children still hospitalized and treated for ITP despite conservative guidelines, Parent behavior training treats preschoolers at risk for ADHD, AAP supports same-sex marriage and parenting, Low birth weight children show neurobehavioral impairments, Study explores daily iron supplementation in 2- to 5-year-olds, New guidelines for pediatric acute otitis media released 

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain. 

Tags: Clinical trialsdiarrheahealthinfectioninfectious diseasenutritionpediatricsProphylaxissupplementationzinc
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