Zinc during and in convalescence from diarrhea has no demonstrable effect on subsequent morbidity and anthropometric status among infants <6 mo of age.
What this study found
Zinc did not improve subsequent morbidity or growth compared with placebo, and infants receiving zinc had more days of diarrhea. Over 8 weeks of follow-up, there were no significant differences in change in WAZ, LAZ, or WLZ, and morbidity outcomes were also null: diarrhea incidence rate RR = 1.02; days of diarrhea RR = 1.22; any respiratory infection or pneumonia RR = 1.00; pneumonia RR = 1.04. The authors concluded that young infants do not appear to benefit from this short course of zinc, unlike older children.
- Study & population
- Randomized, placebo-controlled trial in very young infants 1-5 months of age with acute diarrhea enrolled in low-income districts of Addis Ababa, Ethiopia; Karachi, Pakistan; and New Delhi, India.
- Intervention
- The active regimen was zinc sulfate 10 mg/day as a dispersible oral tablet, given once daily for 14 days during and after an acute diarrhea episode, compared with placebo.
- Key limitation
- The intervention was brief, with only 14 days of zinc and 8 weeks of follow-up.
View source
Open PDFOriginal abstract
BACKGROUND Preventing illness and improving growth in the first 6 mo of life is critical to reducing infant mortality. Zinc given for 14 d at the start of diarrhea has been shown to decrease the incidence and prevalence of diarrhea and pneumonia and improve growth in the 2-3 mo after, but no trial has been done in infants <6 mo of age. OBJECTIVE This study sought to assess the effect of 14 d of zinc supplementation on subsequent morbidity and growth among infants 1-5 mo of age living in Pakistan, India, and Ethiopia. DESIGN Infants with acute diarrhea were randomly assigned to receive zinc (10 mg/d; n = 538) or placebo (n = 536) for 2 wk. Weekly follow-up visits were conducted for 8 wk after the diarrhea episode. Incidence and prevalence of diarrhea and prevalence of respiratory infections including pneumonia were compared between the groups. Changes in weight, length, and corresponding z scores during the 8 wk of follow-up were also compared. RESULTS One thousand seventy-four infants were enrolled at the start of follow-up. The groups did not differ significantly in the proportion of infants with at least one episode of diarrhea or respiratory infections. Infants who received zinc had more days of diarrhea (rate ratio = 1.20) than did the infants who received placebo. The groups had similar prevalences of pneumonia and overall respiratory infections. No significant differences in the mean changes in weight-for-age, length-for-age, and weight-for-length z scores were observed between the groups overall or in stratified analyses. CONCLUSION Young infants do not appear to benefit from 2 wk of zinc, unlike what has been observed among older children.