Impact of zinc supplementation in children with acute diarrhoea in Turkey

Objective: Zinc deficiency is prevalent in children in developing countries. Supplemental zinc provides therapeutic benefits in diarrhoea. Our aim was to evaluate the effect of daily zinc supplementation for 14 days on diarrhoea duration, severity, and morbidity in children. Methods: In a randomised, open label non-placebo controlled trial, we assessed the efficacy of providing zinc sulfate to 6 - 60 month old children with acute diarrhoea for 2 weeks followed by 3 months of morbidity surveillance. Children were randomly assigned to zinc (n = 150) and control ( n = 130) groups and received 15 - 30 mg elemental zinc daily. Results: Supplemented children had significantly improved plasma zinc levels by day 14 of therapy. Zinc deficiency was observed in 2.6% of the treatment and 3.3% of the control group. The mean duration of diarrhoea after starting supplementation was 3.02 +/- 2 days in the zinc group and 3.67 +/- 3.2 days in the control group. There was no significant difference in diarrhoea duration by treatment group (p > 0.05). The number of stools after starting supplementation was 5.8 +/- 3.7 and 5.1 +/- 3.9 on day 1, 2.9 +/- 1.6 and 3.0 +/- 2.2 on day 2, and 1.8 +/- 1.1 and 1.6 +/- 0.9 on day 3 in the zinc and control groups, respectively. There was no significant difference in diarrhoea severity by treatment group (p > 0.05). No significant effect was found on the incidence and prevalence of diarrhoea in the zinc compared with the control group. Conclusion: Our data indicate that supplementing children with acute diarrhoea in Turkey with 3 RDA of elemental zinc for 14 days improved neither diarrhoea duration nor severity despite significant increments in plasma zinc.