Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial

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BioMed Central

Open Access

Research article

Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial Archana Patel*1,2, Michael J Dibley3, Manju Mamtani1, Neetu Badhoniya1 and Hemant Kulkarni1 Address: 1Lata Medical Research Foundation, Nagpur, India, 2Indira Gandhi Government Medical College, Nagpur, India and 3The School of Public Health and the George Institute for International Health, University of Sydney, Sydney, NSW, Australia Email: Archana Patel* - [email protected]; Michael J Dibley - [email protected]; Manju Mamtani - [email protected]; Neetu Badhoniya - [email protected]; Hemant Kulkarni - [email protected] * Corresponding author

Published: 5 May 2009 BMC Medicine 2009, 7:22

doi:10.1186/1741-7015-7-22

Received: 26 March 2009 Accepted: 5 May 2009

This article is available from: http://www.biomedcentral.com/1741-7015/7/22 © 2009 Patel et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background: Diarrhea causes an estimated 2.5 million child deaths in developing countries each year, 35% of which are due to acute diarrhea. Zinc and copper stores in the body are known to be depleted during acute diarrhea. Our objectives were to evaluate the efficacy of zinc and copper supplementation when given with standard treatment to children with acute watery or bloody diarrhea. Methods: We conducted a double-blind randomized controlled clinical trial in the Department of Pediatrics at Indira Gandhi Government Medical College Nagpur, India. Eight hundred and eight children aged 6 months to 59 months with acute diarrhea were individually randomized to placebo (Pl), zinc (Zn) only, and zinc and copper (Zn+Cu) together with standard treatment for acute diarrhea. Results: The mean duration of diarrhea from enrolment and the mean stool weight during hospital stay were 63.7 hours and 940 grams, respectively, and there were no significant differences in the adjusted means across treatment groups. Similarly, the adjusted means of the amount of oral rehydration solution or intravenous fluids used, the proportion of participants with diarrhea more than 7 days from onset, and the severity of diarrhea indicated by more than three episodes of some dehydration or any episode of severe dehydration after enrolment, did not differ across the three groups. Conclusion: The expected beneficial effects of zinc supplementation for acute diarrhea were not observed. Therapeutic Zn or Zn and Cu supplementation may not have a universal beneficial impact on the duration of acute diarrhea in children. Trial registration: The study was registered as an International Standard Randomized Controlled Trial (ISRCTN85071383).

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