Effect of Zinc supplementation on the Management of Acute Diarrhoea in Young Children in Jos, Nigeria: A Double-Blind Randomised Placebo Controlled Clinical Trial.

Abstract

Diarrhoea is second only to malaria as a cause of death in under five children in Nigeria. Episodes of acute diarrhoea tend to resolve within a few days in healthy children but persist longer in children with malnutrition, impaired cellular immunity and recurrent diarrhoea. Diarrhoea is very common in severe zinc deficient children and has been reported to respond to zinc supplementation as an adjunct to the combined use of oral rehydration therapy and early continued feeding. We study the effect of Zinc supplementation on the severity, duration and recurrence of acute diarrhoea in children in a hospital-based randomized placebo controlled clinical trial at JUTH in Jos. Seventy children 2-24 months of age who were reported to have passed at least 3 or more unformed stools in the previous 24 hours and have had diarrhoea for 7 days or less were randomized to receive Zinc (20mg/day n= 35) or placebo (n= 35) for 14 days. Each patient also had the low osmolar UNICEF-ORS at 75mls/kg. and the child's usual feeds. Weekly follow-up visits were conducted for 12 weeks after the diarrhea episode. Incidence and prevalence of diarrhea were compared between the groups. Neither the attending clinician nor the patient nor the data analyst was aware of who was on the Zinc or the Placebo. 57 children completed 14 days zinc supplementation, however only 54 children completed the three months post zinc supplementation follow-up. Zinc reduces the average number of watery stools by 37% and the mean duration of diarrhea by 39%. zxeZinc supplementation significantly reduced the risk of recurrence of acute diarrhoea by 38%. Supplementing the treatment of acute watery diarrhea with Zinc in just 2 cases will prevent recurrence of diarrhea in one of the children in the following 12 weeks. Fourteen days supplementation of Zinc in the treatment of acute diarrhea in children significantly reduced the average number of watery stools and duration of acute diarrhea. It also reduces the recurrence of diarrhea within three months of completion of supplementation. Zinc supplementation of acute diarrhea management in just two children will prevent diarrhea recurrence in the next three months in at least one child.

Keywords: Acute watery Diarrhoea in Children; Zinc supplementation