Zinc supplementation reduces the incidence of persistent diarrhea and dysentery among low socioeconomic children in India
Open accessAbstract
Persistent diarrhea (PD) and dysentery (DD) account for most diarrhea-associated deaths among children in developing countries. Zinc deficiency can cause stunting and impaired immune function, both of which are risk factors for these diarrheal illnesses. We investigated the effect of zinc supplementation on the incidence of PD and DD in a community-based, double-blind randomized trial in children 6-35 mo of age. Increase over baseline in plasma zinc concentrations in the supplemented group compared with a control group (3.61 vs. 0.009 mumol.L-1), indicated successful supplementation. The overall reductions in the zinc supplemented group of 21% in the incidence of PD (95% CI -6 to 42%) and 14% in the incidence of dysentery (95% CI -15 to 36%) were not significant. There was a significant interaction of treatment effect with baseline plasma zinc concentration and age for PD and with gender for DD. In the zinc-supplemented group compared with the control group, the incidence of PD was reduced by 73% (P < 0.05; 95% CI 34 to 91%) in children with a baseline zinc < 7.65 mumol.L-1 and by 49% (P < 0.05; 95%CI 24 to 66%) in children > 11 mo of age. Zinc supplementation resulted in a 38% (P < 0.05 95%CI 8 to 59%) reduction in the incidence of DD in boys. There was no effect on PD among children 6-11 mo old or on DD in girls. In conclusion, zinc supplementation had a significant impact on the incidence of persistent diarrhea in children > 1 y old and in children with low plasma zinc, as well as on dysentery in boys. These findings may have important implications for reducing diarrhea-related morbidity and mortality.
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Controlled trials of zinc supplementation in infants and children showed a reduction of up to 50% in incidence of pneumonia.
“Controlled trials of zinc supplementation in infants and children showed a 25-30% reduction in the incidence and duration of acute and chronic diarrhea and a reduction of up to 50% in the incidence of pneumonia (30 -32).”
From Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress (2007) · cites this paper as [31]
Controlled trials of zinc supplementation in infants and children showed a 25-30% reduction in incidence and duration of acute and chronic diarrhea.
“Controlled trials of zinc supplementation in infants and children showed a 25-30% reduction in the incidence and duration of acute and chronic diarrhea and a reduction of up to 50% in the incidence of pneumonia (30 -32).”
From Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress (2007) · cites this paper as [31]
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Cites
Physical growth: National Center for Health Statistics percentiles
Hamill, P. V. V., Drizd, T. A., Johnson, C., Reed, R. B., Roche, A., & Moore, W. (1979) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/32.3.607 · Cited by 2,322 · see citing works
McCullagh, P. J. (1983) · The Annals of Statistics · doi:10.1214/aos/1176346056 · Cited by 771 · see citing works
ACRODERMATITIS ENTEROPATHICA: A LETHAL INHERITED HUMAN ZINC-DEFICIENCY DISORDER
Moynahan, E. J. (1974) · The Lancet · doi:10.1016/s0140-6736(74)91772-3 · Cited by 626 · see citing works
Beisel, W. R. (1982) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/35.2.417 · Cited by 517 · see citing works
Zinc Supplementation in Young Children with Acute Diarrhea in India
Sazawal, S., Black, R. E., Bhan, M. K., Bhandari, N., Sinha, A., & Jalla, S. (1995) · New England Journal of Medicine · doi:10.1056/nejm199509283331304 · Cited by 383 · see citing works
Self-citationNutritional influences on linear growth: a general review.
Allen, L. H. (1994) · PubMed · Cited by 299 · see citing works
Black, R. E., Brown, K. H., & Becker, S. (1984) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/39.1.87 · Cited by 265 · see citing works
Self-citationTrace mineral balance during acute diarrhea in infants
Castillo‐Durán, C., Vial, P., & Uauy, R. D. (1988) · The Journal of Pediatrics · doi:10.1016/s0022-3476(88)80627-9 · Cited by 186 · see citing works
Persistent diarrhea in children of developing countries
Black, R. E. (1993) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199309000-00010 · Cited by 146 · see citing works
Self-citationA Controlled Trial on Utility of Oral Zinc Supplementation in Acute Dehydrating Diarrhea in Infants
Sachdev, H. S., Mittal, N. K., Mittal, S. K., & Yadav, H. (1988) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-198811000-00015 · Cited by 120 · see citing works
Zinc requirements and zinc intakes of breast-fed infants
Krebs, N., & Hambidge, K. M. (1986) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/43.2.288 · Cited by 118 · see citing works
ZINC DEFICIENCY AND INTRAVENOUS FEEDING
Kay, R. G., & Tasman-Jones, C. (1975) · The Lancet · doi:10.1016/s0140-6736(75)90194-4 · Cited by 102 · see citing works
Hambidge, K. M. (1992) · Acta Paediatrica · doi:10.1111/j.1651-2227.1992.tb12377.x · Cited by 92 · see citing works
Bhandari, N., Bhan, M. K., & Sazawal, S. (1994) · BMJ · doi:10.1136/bmj.309.6966.1404 · Cited by 91 · see citing works
Self-citationVictora, C. G., Huttly, S. R., Sc, F., et al. (1993) · PubMed · Cited by 82 · see citing works
Statistical Modelling in GLIM.
Lachenbruch, P. A., Aitken, M., Anderson, D., et al. (1990) · Journal of the American Statistical Association · doi:10.2307/2289576 · Cited by 70 · see citing works
Bhandari, N., Bhan, M. K., & Sazawal, S. (1992) · Acta Paediatrica · doi:10.1111/j.1651-2227.1992.tb12363.x · Cited by 65 · see citing works
Self-citationPersistent diarrhea as a cause of childhood mortality in rural Bangladesh
Fauveau, V., Henry, F. J., Briend, A., et al. (1992) · Acta Paediatrica · doi:10.1111/j.1651-2227.1992.tb12365.x · Cited by 63 · see citing works
Oral zinc supplementation in persistent diarrhoea in infants
Sachdev, H. S., Mittal, N. K., & Yadav, H. S. (1990) · Annals of Tropical Paediatrics · doi:10.1080/02724936.1990.11747411 · Cited by 58 · see citing works
Baqui, A., Sack, R. B., Black, R. E., Chowdhury, H. R., Yunus, M., & Siddique, A. (1993) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/58.4.543 · Cited by 53 · see citing works
Self-citationEffect of diarrhea on serum zinc concentrations in infants and children
Naveh, Y., Lightman, A., & Zinder, O. (1982) · The Journal of Pediatrics · doi:10.1016/s0022-3476(82)80303-x · Cited by 48 · see citing works
Pre-breakfast plasma zinc concentrations: the effect of previous meals.
Km, H., Jc, K., Kern, D. L., et al. (1990) · PubMed · Cited by 44 · see citing works
Black, R. E., Lanata, C. F., & Lazo, F. V. (1989) · PubMed · Cited by 43 · see citing works
Self-citationDiarrhoea Mortality in Rural Bangladeshi Children
Fauveau, V., Yunus, M., Zaman, K., et al. (1991) · Journal of Tropical Pediatrics · doi:10.1093/tropej/37.1.31 · Cited by 33 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- SAS Technical Report (1993) Confidence intervals for parameters. In: SAS Institute Inc., SAS Technical Report P-243, SAS/Stat Soft ware: The GENMOD procedure 6.09, pp. 3-6. SAS Institute Inc., Cary, NC.
Cited by
Sorted by citations
Zinc and immune function: the biological basis of altered resistance to infection
Shankar, A. H., & Prasad, A. S. (1998) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/68.2.447s · Cited by 1,606 · see citing works
Bhutta, Z. A., Black, R. E., Brown, K. H., Gardner, J. M., Gore, S., Hidayat, A., Khatun, F., Martorell, R., Ninh, N. X., Penny, M. E., et al. (1999) · The Journal of Pediatrics · doi:10.1016/s0022-3476(99)70086-7 · Cited by 731 · see citing works
Self-citationSazawal, S., Black, R. E., Jalla, S., Mazumdar, S., Sinha, A., & Bhan, M. K. (1998) · Pediatrics · doi:10.1542/peds.102.1.1 · Cited by 543 · see citing works
Self-citationPrasad, A. S., Beck, F. W., Bao, B., Fitzgerald, J. T., Snell, D. C., Steinberg, J. D., & Cardozo, L. J. (2007) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.3.837 · Cited by 516 · see citing works
Sazawal, S., Black, R. E., Ramsan, M., Chwaya, H. M., Dutta, A., Dhingra, U., Stoltzfus, R. J., Othman, M. K., & Kabole, F. M. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60452-8 · Cited by 138 · see citing works
Self-citationBolick, D. T., Kolling, G. L., Moore, J. H., de Oliveira, L. A., Tung, K., Philipson, C., Viladomiu, M., Hontecillas, R., Bassaganya-Riera, J., & Guerrant, R. L. (2014) · Gut Microbes · doi:10.4161/19490976.2014.969642 · Cited by 76 · see citing works
Zinc supplementation for the prevention of pneumonia in children aged 2 months to 59 months
Lassi, Z. S., Haider, B. A., & Bhutta, Z. A. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005978.pub2 · Cited by 71 · see citing works
- Authors
- Sazawal, S., Black, R. E., Bhan, M. K., Jalla, S., Bhandari, N., Sinha, A., & Majumdar, S.
- Affiliations
- Johns Hopkins University (US)
- Indian Council of Medical Research (IN)
- Corresponding author
- Black, Robert E.
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 1996-02
- Volume
- 126
- Issue
- 2
- Pages
- 443-450
- ISSN
- 0022-3166 (ISSN-L)
- OpenAlex
- W1942860958
- Cited by
- 146
- References
- 24
- Citations by year
- 2026: 1 · 2023: 2 · 2021: 2 · 2020: 1 · 2019: 3 · 2016: 8 · 2015: 3 · 2014: 9 · 2013: 8 · 2012: 3
- FWCI
- 13.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Keywords
- zinc supplementation, persistent diarrhea, dysentery, childhood diarrhea, zinc deficiency, plasma zinc, low socioeconomic status, children under five, sex differences, age differences, diarrhea incidence
- MeSH terms
- Child, Preschool, Diarrhea, Double-Blind Method, Dysentery, Female, Food, Fortified, Humans, India, Infant, Male, Poverty, Socioeconomic Factors, Zinc, Incidence
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