Shorter course of zinc therapy as effective as longer treatment for diarrhea

February 2011

Current WHO/UNICEF diarrhea management guidelines include 10- to 14-day zinc treatment as an adjunct therapy during acute childhood diarrhea based on earlier trials showing substantial reductions in both the duration of the current episode and in preventing diarrhea in the three months post supplementation. However, challenges arose in implementing this policy, as mothers would often stop giving zinc after three to five days as their child’s symptoms went away. Even with intensive campaigns and motivation, studies have shown that adherence lasts only 7 of the intended 14 days. In February 2011, the Journal of Nutrition published findings from a randomized trial conducted in Bangladesh. The authors determined that a shorter course of zinc therapy (five days) is as effective as the standard zinc therapy (ten days) on the incidence and duration of diarrhea among young children (ages 4–59 months). In this study of over 1,600 children, the mean number of repeat episodes did not differ between five days or ten days of zinc treatment, nor did the proportion of children having at least one episode of diarrhea during the 90-day observation period. This study has practical significance because zinc supplementation has been shown to be associated with increased vomiting in young children, suggesting that a shorter course of zinc therapy may be desirable to avoid unnecessary vomiting. Moreover, it cuts treatment costs by 50 percent. While these data strongly suggest using a five-day regime, larger-scale effectiveness studies are needed to assess the preventive efficacy in a less-controlled environment.

Zinc Treatment for 5 or 10 Days Is Equally Efficacious in Preventing Diarrhea in the Subsequent 3 Months Among Bangladeshi Children