Zinc supplementation in the management of diarrhoea
Diarrhoea remains a leading cause of death globally among children under five years of age. Diarrhoea contributes to nutritional deficiencies, reduced resistance to infections and impaired growth and development. Severe diarrhoea leads to fluid loss, and may be life-threatening, particularly in young children and people who are already malnourished or have impaired immunity.
Zinc is important for cellular growth, cellular differentiation and metabolism and deficiency limits childhood growth and decreases resistance to infections. Although severe zinc deficiency is rare in humans, mild to moderate deficiency may be common worldwide.
Zinc supplementation has been shown to reduce the duration and severity of diarrhoea, and to prevent subsequent episodes, although the mechanisms by which zinc exerts its anti-diarrhoeal effect are not fully understood.
WHO recommendations
Mothers, other caregivers and health workers should provide children with 20 mg per day of zinc supplementation for 10-14 days (10 mg per day for infants under the age of six months).
WHO documents
GRC-approved guidelines
Status: not currently available
Other guidance documents
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Implementing the new recommendations on the clinical management of diarrhoea : guidelines for policy makers and programme managers
Publication date: 2006 -
The treatment of diarrhoea: A manual for physicians and other senior health workers
Publication date: 2005 -
Clinical management of acute diarrhoea: a WHO and UNICEF joint statement
Publication date: 2004
Evidence
Related Cochrane reviews
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Oral zinc for treating diarrhoea in children
Lazzerini M, Wanzira H.
Cochrane Database of Systematic Reviews. 2016; Issue 12. Art. No.: CD005436. -
Zinc supplementation for preventing mortality, morbidity, and growth failure in children aged 6 months to 12 years of age
Mayo-Wilson E, Junior JA, Imdad A, Dean S, Chan XHS, Chan ES, et al.
Cochrane Database of Systematic Reviews. 2014; Issue 5. Art. No.: CD009384. - Summary of this review
Other related systematic reviews
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Oral zinc supplementation for the treatment of acute diarrhea in children: A systematic review and meta-analysis
Lamberti, L.M, Walker CLF, Chan KY, Jian WY, Black RE.
Nutrients. 2013;5(11):4715-40. -
Preventive zinc supplementation in developing countries: impact on mortality and morbidity due to diarrhea, pneumonia and malaria
Yakoob MY, Theodoratou E, Jabeen A, Imdad A, Eisele TP, Ferguson J, et al.
BMC Public Health. 2011;11 Suppl 3:S23. -
Zinc for the treatment of diarrhoea: effect on diarrhoea morbidity, mortality and incidence of future episodes.
Fischer Walker CL, Black RE.
International Journal of Epidemiology. 2010; 39(Suppl. 1):i63–i69. -
Therapeutic value of zinc supplementation in acute and persistent diarrhea: a systematic review
Patel A, Mamtani M, Dibley MJ, Badhoniya N, Kulkarni H.
PloS One. 2010;5(4):e10386. -
A meta-analysis of the effects of oral zinc in the treatment of acute and persistent diarrhea.
Lukacik M, Thomas RL, Aranda JV.
Pediatrics. 2008; 121(2):326–336. -
Role of zinc administration in prevention of childhood diarrhea and respiratory illnesses: a meta-analysis.
Aggarwal R, Sentz J, Miller MA.
Pediatrics. 2007; 119(6):1120–1130. -
Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomized controlled trials
Bhutta ZA, Bird SM, Black RE, Brown KH, Gardner JM, Hidayat A, et al.
American Journal of Clinical Nutrition. 2000; 72(6):1516–1522.
