Potential benefits of zinc with oral rehydration solution to treat diarrhea in young infants

October 2010

In the October 2010 issue of the Bulletin of the World Health Organization, researchers reported a reduction in episodes of diarrhea and acute lower respiratory infection (ALRI) as well as reduced hospitalizations among infants younger than 6 months after they received a diarrhea treatment intervention providing education on zinc together with access to zinc tablets and oral rehydration solution (ORS). The findings came out of a subgroup analysis of the authors’ previously reported cluster-randomized trial in India.

For children 6 months to 4 years of age, zinc supplementation with ORS for the treatment of acute diarrhea has been shown to reduce the duration and severity of a current diarrhea episode and to protect against diarrhea and ALRI morbidity for two to three subsequent months. For infants younger than 6 months, however, data about the efficacy of this intervention are limited.

The original trial showed that zinc and ORS intervention was more effective than ORS alone at reducing the prevalence of acute diarrhea, ALRI, and hospitalizations for diarrhea and pneumonia. Findings from the 0- to 5-month subgroup analysis were similar. After three months of intervention, the authors found episodes of diarrhea to be 34 percent and 40 percent fewer in the previous 24 hours and 14 days, respectively. After six months, they found 41 percent fewer ALRI episodes in the previous 24 hours, 28 percent fewer diarrhea episodes in the previous 14 days, and fewer hospitalizations due to diarrhea, ALRI, and all causes.

The authors suggested that the lower incidence of diarrhea and ALRI in the subgroup reflects carryover protection after treatment of a previous acute diarrhea episode. Although they acknowledged that retrospective subgroup comparisons should be interpreted with caution, they suggested additional research on this intervention because of the high proportion of diarrhea and ALRI deaths among infants younger than 6 months of age.

Effectiveness of zinc supplementation plus oral rehydration salts for diarrhoea in infants aged less than 6 months in Haryana state, India