The role of zinc and vitamin a supplementation in young children with persistent diarrhea

الملخص EN

Background : Zinc deficiency is prevalent in children in developing countries. Supplemental zinc and vitamin A provides therapeutic benefits in persistent diarrhea. Objective : To evaluate the effect of supplemental zinc given with vitamin A therapy in the management of persistent diarrhea. Design : The study was conducted in Karbala Teaching Hospital for Children.

Children of the age 6-24 months with persistent diarrhea (diarrhea that last for at least 14 days with growth faltering) were enrolled in this study.

The children randomly assigned to two groups ; group A (n = 59) received zinc supplement 3-5 mg/kg/day of elemental zinc sulfate in a single daily dose for 14 days and vitamin A 100000 units to children 6-12 months old and 200000 units to children above 12 months and control group (group B) (n = 58).

Both groups received nutritional support with a rice-lentil (Khitchri), yogurt and home available diets was initiated, Breastfeeding was continued as required and low osmolality oral rehydration solution was used also .

Stool output, (consistency, frequency) and body weight were recorded daily during days of admission (3-5 days). Stature, occipito-frontal circumference, weight-for-age, stature-for-age percentile are defined on standard growth charts and weight for height SD were determined.

These anthropometric measurements were repeated at days 7, 14, and 28 after discharge from hospital. Results : The baseline characteristics of the 2 study groups were comparable.

The total diarrheal stool output, (consistency, frequency) among the 2 groups over 3-5 days were significantly different.

The percentage of children who had clinical recovery (passage of soft stool was taken as recovery) within 5 days were significantly greater in the zinc and vitamin A group (86 %) compared to the control group (48 %).

The net gain in the body weight over the 28day study period was significant only in the children receiving zinc and vitamin A group compared to the control group. Conclusion : Zinc and vitamin A supplementation in persistent diarrhoea reduces stool output along with frequency, and promotes earlier recovery.