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a Clinical
Sciences Division, International Centre for Diarrhoeal Diseases
Research, Dhaka, Bangladesh, b Centre
for International Child Health, Institute of Child Health,
London, c Clinical Nutrition Unit, Department
of Clinical Sciences, London School of Hygiene and Tropical Medicine,
London
Correspondence to: Dr S K Roy, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box 128, Mohakhali, Dhaka 1000, Bangladesh.
Accepted 13 June 1997
OBJECTIVE
To evaluate the impact of zinc
supplementation on the clinical course, stool weight, duration of
diarrhoea, changes in serum zinc, and body weight gain of children with
acute diarrhoea.
DESIGNRandomised double blind controlled trial.
Children were assigned to receive zinc (20 mg elemental zinc per day)
containing multivitamins or control group (zinc-free multivitamins)
daily in three divided doses for two weeks.
SETTINGA diarrhoeal disease hospital in Dhaka, Bangladesh.
PATIENTS111 children, 3 to 24 months old,
below 76% median weight for age of the National Center for Health
Statistics standard with acute diarrhoea. Children with severe
infection and/or oedema were excluded.
MAIN OUTCOME MEASURESTotal diarrhoeal stool
output, duration of diarrhoea, rate of weight gain, and changes in
serum zinc levels after supplementation.
RESULTSStool output was 28% less and duration
14% shorter in the zinc supplemented group than placebo (p = 0.06).
There were reductions in median total diarrhoeal stool output among
zinc supplemented subjects who were shorter (less than 95% height for
age), 239 v 326 g/kg (p < 0.04), and who had a lower
initial serum zinc (< 14 mmol/l), 279 v 329 g/kg (p < 0.05); a shortening of mean time to recovery occurred (4.7 v 6.2 days, p < 0.04) in those with lower serum zinc.
There was an increase in mean serum zinc in the zinc supplemented group
(+2.4 v 
0.3 µmol/l, p < 0.001) during two weeks of
supplementation, and better mean weight gain (120 v 30 g,
p < 0.03) at the time of discharge from hospital.
CONCLUSIONSZinc supplementation is a
simple, acceptable, and affordable strategy which should be considered
in the management of acute diarrhoea and in prevention of growth
faltering in children specially those who are malnourished.
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