LAUSR

BACKGROUND Diarrhoea causes 15% of under-5 mortality in developing countries. Zinc (Zn) stores in the body are known to be depleted during acute diarrhoea. The aim of this study was to evaluate the efficacy of Zn given with standard treatment to children with acute or moderate diarrhoea. METHODS In this quasi-unmasked, parallel-group study, we enrolled children with diarrhoea at El-Dorra Paediatric Hospital, Gaza Strip, occupied Palestinian territory. Inclusion criteria were children with more than three unformed stools in the preceding 24 h, duration of diarrhoea up to 72 h, and ability to accept oral fluids or feeds. Recruited children were assigned equally to either oral rehydration salts (control group) or oral rehydration salts plus Zn sulphate (Zn group; 10 mg for children younger than 6 months; 20 mg for children aged 6 months and older). All treatments were taken orally for 14 days. Primary outcomes were duration and frequency of diarrhoea. Secondary outcomes included changes in bodyweight, drugs side-effects, and episodes of any or severe dehydration. Data were analysed with SPSS. Outcome measures were compared with the Mann-Whitney U-test, student's t test, odds ratio, or χ2 test. The study was approved by the ministry of health and the Helsinki Committee in the Gaza Strip. Parents of the children provided verbally informed consent before participation. FINDINGS We enrolled 140 children (aged 1-120 months). Duration of diarrhoea in the Zn group was shorter than in the control group (2·34 days in the Zn group vs 7·20 days in the control group; p<0·0001). The frequency of diarrhoea was also reduced to a greater extent in the Zn group than in the control group (from 6·38 times daily before treatment to 2·38 times daily after treatment vs from 6·99 times daily to 4·68 times daily after treatment). Bodyweight increased in 50 (71%) children in the Zn group, whereas 50 (71%) children in the control group lost bodyweight during the treatment period (p<0·0001). Constipation was seen in two (3%), 12 (18%), and ten (15%) children in the Zn group on days 5, 6, and 7 of treatment, respectively, whereas none of the children in the control group had constipation at any time (p=1·51 for day 5; p<0·0001 for day 6; and p=0·001 for day 7). INTERPRETATION Zinc supplementation added to standard treatment with oral rehydration salts was effective and resulted in good treatment of diarrhoea. FUNDING None.