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Zinc supplementation in children with cholera in Bangladesh: randomised controlled trial
S K Roy1, M Jahangir Hossain, Wajiha Khatun
1International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka -1212, Bangladesh. skroy@icddrb.org
Insights
Zinc supplementation significantly reduces cholera duration and severity in children. This study found that children receiving zinc recovered faster and had less stool output compared to placebo.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Cholera remains a significant cause of childhood morbidity and mortality globally.
- Early interventions are crucial to reduce the duration and severity of cholera symptoms.
Purpose of the Study:
- To investigate the therapeutic impact of zinc supplementation in pediatric cholera patients.
- To assess the effect of zinc on cholera recovery time and fluid loss.
Main Methods:
- A double-blind, randomized, placebo-controlled trial was conducted at Dhaka Hospital, Bangladesh.
- 179 children (aged 3-14 years) with confirmed cholera received either 30 mg elemental zinc daily or a placebo, alongside standard erythromycin treatment.
- Study outcomes included duration of diarrhea and total stool output.
Main Results:
- Zinc supplementation led to a significantly higher recovery rate by day two (49% vs. 32%) and day three (81% vs. 68%).
- Children receiving zinc experienced a 12% shorter duration of diarrhea (64.1 vs. 72.8 hours).
- Total stool output was reduced by 11% in the zinc group compared to the placebo group.
Conclusions:
- Zinc supplementation is an effective intervention for reducing the duration and severity of cholera in children.
- The findings support the routine use of zinc supplementation in pediatric cholera management to improve clinical outcomes.
Objective:
To investigate the impact of zinc supplementation in children with cholera.
Design:
Double blind, randomised, placebo controlled trial.
Setting:
Dhaka Hospital, Bangladesh.
Participants:
179 children aged 3-14 years with watery diarrhoea and stool dark field examination positive for Vibrio cholerae and confirmed by stool culture.
Intervention:
Children were randomised to receive 30 mg elemental zinc per day (n=90) or placebo (n=89) until recovery. All children received erythromycin suspension orally in a dose of 12.5 mg/kg every six hours for three days.
Main Outcome Measures:
Duration of diarrhoea and stool output. Results 82 children in each group completed the study. More patients in the zinc group than in the control group recovered by two days (49% v 32%, P=0.032) and by three days (81% v 68%, P=0.03). Zinc supplemented patients had 12% shorter duration of diarrhoea than control patients (64.1 v 72.8 h, P=0.028) and 11% less stool output (1.6 v 1.8 kg/day, P=0.039).
Conclusion:
Zinc supplementation significantly reduced the duration of diarrhoea and stool output in children with cholera. Children with cholera should be supplemented with zinc to reduce its duration and severity.
Trial Registration:
Clinical trials NCT00226616.
