Zinc Supplementation During Diarrhea Reduces Morbidity and Mortality in Bangladeshi Children

Zinc supplementation given to children suffering from diarrheal disease greatly reduced their risk of death and illness, according to a study conducted by an international team of scientists working in Bangladesh and led by researchers from the Johns Hopkins Bloomberg School of Public Health. The researchers found the incidence of diarrhea was significantly less and non-injury deaths were 50 percent less in children who received zinc compared to those who did not. In addition, they found that oral rehydration solution therapy (ORS) use, which is one of the standard treatments for diarrheal disease, increased by 20 percent among the children who received zinc. Antibiotic use decreased by 60 percent among the same group. These findings are published in the November 9, 2002, of the British Medical Journal.

“The lower rates of child morbidity and mortality with zinc therapy represent substantial benefits from a simple and inexpensive intervention,” explained the study’s lead author Abdullah Baqui, MBBS, MPH, DrPH, associate professor of international health at the Johns Hopkins Bloomberg School of Public Health. “Zinc can be incorporated within existing diarrheal disease control efforts, which should significantly improve child health and survival,” he added.

For the study, the researchers treated 8,070 children with diarrhea living in areas of Bangladesh. Groups of children were randomized by region to receive zinc in addition to standard treatments and compared to children who did not receive zinc. The children in the zinc areas received 20 mg elemental zinc daily for 14 days during each episode of diarrhea in addition to ORS therapy.

Despite many advances, diarrheal diseases and the resulting dehydration are still responsible for about 2 million child deaths every year. Most cases occur in developing, resource-poor countries, where children suffer from malnutrition, and access to clean water, safe sanitation, and health facilities are limited.

A recent World Health Organization meeting reviewed the findings of this and other zinc trials and concluded that zinc supplements are efficacious in reducing the severity and duration of diarrhea and recommended that additional effectiveness studies should assess the feasibility of this intervention and the effects on antibiotic use, non-diarrheal morbidity, and overall child mortality.

Research was conducted by scientists at Johns Hopkins Bloomberg School of Public Health, ICDDR,B: Center for Health and Population Research, Bangladesh, and London School of Hygiene and Tropical Medicine.

The study was supported by the Johns Hopkins Family Health and Child Survival Cooperative Agreement and ICCDR,B Cooperative Agreement with funding from the US Agency for International Development.