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Oral zinc for treating diarrhoea in children

  1. Marzia Lazzerini1,*,
  2. Luca Ronfani2

Editorial Group: Cochrane Infectious Diseases Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 30 NOV 2010

DOI: 10.1002/14651858.CD005436.pub2

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How to Cite

Lazzerini M, Ronfani L. Oral zinc for treating diarrhoea in children. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD005436. DOI: 10.1002/14651858.CD005436.pub2.

Author Information

  1. 1

    WHO Collaborating Centre for Maternal and Child Health, Unit of Research on Health Services and International Health, Trieste, Italy

  2. 2

    IRCCS Burlo Garofolo, Unit of Clinical Epidemiology and Biostastics, Trieste, Italy

*Marzia Lazzerini, Unit of Research on Health Services and International Health, WHO Collaborating Centre for Maternal and Child Health, Via dei Burlo 1,34123, Trieste, Italy. lazzerini@burlo.trieste.it.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 16 JUL 2008

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Al-Sonboli 2003 {published data only}
  • Al-Sonboli N, Gurgel RQ, Shenkin A, Hart CA, Cuevas LE. Zinc supplementation in Brazilian children with acute diarrhoea. Annals of Tropical Paediatrics 2003;23(1):3-8.
  • Cuevas LE, Al Sonboli NN, Gurgel RQ, Shenkins A, Hart CA. Impact of zinc on duration of acute diarrhoea in children [Abstract]. Journal of Infection 2000;40:A29.
Bahl 2002 {published data only}
  • Bahl R, Bhandari N, Saksena M, Strand T, Kumar GT, Bhan MK, et al. Efficacy of zinc-fortified oral rehydration solution in 6- to 35-month-old children with acute diarrhea. Journal of Pediatrics 2002;141(5):677-82.
Bhatnagar 2004a {published data only}
  • Bhatnagar S, Bahl R, Sharma PK, Kumar GT, Saxena SK, Bhan MK. Zinc with oral rehydration therapy reduces stool output and duration of diarrhea in hospitalized children: a randomized controlled trial. Journal of Pediatric Gastroenterology and Nutrition 2004;38(1):34-40.
Bhutta 1999b {published data only}
  • Bhutta ZA, Nizami SQ, Isani Z. Zinc supplementation in malnourished children with persistent diarrhea in Pakistan. Pediatrics 1999;103(4):e42.
Brooks 2005a {published data only}
  • Brooks WA, Santosham M, Roy SK, Faruque AS, Wahed MA, Nahar K, et al. Efficacy of zinc in young infants with acute watery diarrhea. American Journal of Clinical Nutrition 2005;82(3):605-10.
Brooks 2005a (20 mg) {published data only}
  • See Brooks 2005a.
Brooks 2005a (5 mg) {published data only}
Dutta 2000 {published data only}
  • Dutta P, Mitra U, Datta A, Niyogi SK, Dutta S, Manna B, et al. Impact of zinc supplementation in malnourished children with acute watery diarrhoea. Journal of Tropical Pediatrics 2000;46(5):259-63.
Fajolu 2008 {published and unpublished data}
  • Fajolu IB, Emokpae A, Oduwole AO, Silva BO, Abidoye RO, Renner JK. Zinc supplementation in children with acute diarrhoea. Nigerian Quarterly Journal of Hospital Medicine. Nigerian Quarterly Journal of Hospital Medicine. 2008;18(2):101-3.
Faruque 1999 {published data only}
  • Faruque AS, Mahalanabis D, Haque SS, Fuchs GJ, Habte D. Double-blind, randomized, controlled trial of zinc or vitamin A supplementation in young children with acute diarrhoea. Acta Paediatrica 1999;88(2):154-60.
    Direct Link:
Fischer Walker 2006 {published data only}
  • Fischer Walker CL, Bhutta ZA, Bhandari N, Teka T, Shahid F, Taneja S, et al. Zinc supplementation for the treatment of diarrhea in infants in Pakistan, India and Ethiopia. Journal of Pediatric Gastroenterology and Nutrition 2006;43(3):357-63.
Fischer Walker 2006 ETH {published data only}
  • See Fischer Walker 2006.
Fischer Walker 2006 IND {published data only}
Fischer Walker 2006 PAK {published data only}
Khatun 2001 {published data only}
  • Khatun UH, Malek MA, Black RE, Sarkar NR, Wahed MA, Fuchs G, et al. A randomized controlled clinical trial of zinc, vitamin A or both in undernourished children with persistent diarrhea in Bangladesh. Acta Paediatrica 2001;90(4):376-80.
  • Roy SK. A randomized four cell clinical trial of zinc and vitamin A in undernourished children with persistent diarrhoea in Bangladesh. Journal of Pediatric Gastroenterology and Nutrition 1998;26(5):595.
Larson 2005 {published data only}
  • Larson CP, Hoque AB, Larson CP, Khan AM, Saha UR. Initiation of zinc treatment for acute childhood diarrhoea and risk for vomiting or regurgitation: a randomized, double-blind, placebo-controlled trial. Journal of Health, Population, and Nutrition 2005;23(4):311-9.
    Direct Link:
Patel 2009 {published and unpublished data}
  • Patel A, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial. BMC Medicine 2009;5(7):22.
    Direct Link:
Patel 2009a (zinc) {published and unpublished data}
  • Patel A, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial. BMC Medicine 2009;5(7):22.
    Direct Link:
Patel 2009b (zinc+copper) {published and unpublished data}
  • Patel A, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial. BMC Medicine 2009;5(7):22.
Patro 2010 {published and unpublished data}
  • Patro B, Szymanski H, Szajewska H. Oral zinc for the treatment of acute gastroenteritis in polish children: a randomized, double-blind, placebo-controlled trial. Journal of Pediatrics 2010;157(6):984-8.
Penny 1999 {published data only}
  • Penny ME, Peerson JM, Marin RM, Duran A, Lanata CF, Lonnerdal B, et al. Randomized, community-based trial of the effect of zinc supplementation, with and without other micronutrients, on the duration of persistent childhood diarrhea in Lima, Peru. Journal of Pediatrics 1999;135(2 Pt 1):208-17.
Polat 2003 {published data only}
  • Polat TB, Uysalol M, Cetinkaya F. Efficacy of zinc supplementation on the severity and duration of diarrhea in malnourished Turkish children. Pediatrics International 2003;45(5):555-9.
    Direct Link:
Polat 2003 low Zn {published data only}
  • Polat TB, Uysalol M, Cetinkaya F. Efficacy of zinc supplementation on the severity and duration of diarrhea in malnourished Turkish children. Pediatrics International 2003;45(5):555-9.
    Direct Link:
Polat 2003 normal Zn {published data only}
  • Polat TB, Uysalol M, Cetinkaya F. Efficacy of zinc supplementation on the severity and duration of diarrhea in malnourished Turkish children. Pediatrics International 2003;45(5):555-9.
    Direct Link:
Roy 1997 {published data only}
  • Roy SK. Effect of zinc supplementation in patients with acute and persistent diarrhoea. Glimpse 1991;13(3):2.
  • Roy SK, Tomkins AM, Akramuzzaman SM, Behrens RH, Haider R, Mahalanabis D, et al. Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea. Archives of Disease in Childhood 1997;77(3):196-200.
Roy 1998 {published data only}
  • Roy SK. Effect of zinc supplementation in patients with acute and persistent diarrhoea. Glimpse 1991;13(3):2.
  • Roy SK, Tomkins AM, Mahalanabis D, Akramuzzaman SM, Haider R, Behrens RH, et al. Impact of zinc supplementation on persistent diarrhoea in malnourished Bangladeshi children. Acta Paediatrica 1998;87(12):1235-9.
    Direct Link:
Roy 2008 {published and unpublished data}
  • Roy SK, Raqib R, Khatun W, Azim T, Chowdhury R, Fuchs GJ, et al. Zinc supplementation in the management of shigellosis in malnourished children in Bangladesh. European Journal of Clinical Nutrition 2008;62(7):849-55.
Sachdev 1988 {published data only}
  • Sachdev HP, Mittal NK, Mittal SK, Yadav HS. A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants. Journal of Pediatric Gastroenterology and Nutrition 1988;7(6):877-81.
Sachdev 1990 {published data only}
Sazawal 1995 {published data only}
  • Darmon N, Briend A, Desjeux JF. Zinc in the treatment of diarrhea. Journal of Pediatric Gastroenterology and Nutrition 1997;25(3):363-5.
  • Folwaczny C. Role of zinc in treatment of acute diarrhea. Zeitschrift für Gastroenterologie 1996;34(4):260-2.
  • Sazawal S, Black RE, Bhan MK, Bhandari N, Sinha A, Jalla S. Zinc supplementation in young children with acute diarrhea in India. New England Journal of Medicine 1995;333(13):839-44.
Strand 2002 {published data only}
  • Strand TA, Chandyo RK, Bahl R, Sharma PR, Adhikari RK, Bhandari N, et al. Effectiveness and efficacy of zinc for the treatment of acute diarrhea in young children. Pediatrics 2002;109(5):898-903.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Adu Afarwuah 2007 {published data only}
  • Adu-Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: Effects on growth and motor development. American Journal of Clinical Nutrition 2007;86(2):412-20.
Adu-Afarwuah 2008 {published data only}
  • Adu-Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana. The American journal of clinical nutrition 2008;87(4):929-38.
Aggarwal 2007 {published data only}
Agustina 2007 {published data only}
  • Agustina R, Lukito W, Firmansyah A, Suhardjo HN, Murniati D, Bindels J. The effect of early nutritional supplementation with a mixture of probiotic,prebiotic, fiber and micronutrients in infants with acute diarrhea in Indonesia. Asia Pacific Journal of Clinical Nutrition 2007;16(3):435-42.
Alarcon 2004 {published data only}
  • Alarcon K, Kolsteren PW, Prada AM, Chian AM, Velarde RE, Pecho IL, et al. Effects of separate delivery of zinc or zinc and vitamin A on hemoglobin response, growth, and diarrhea in young Peruvian children receiving iron therapy for anemia. American Journal of Clinical Nutrition 2004;80(5):1276-82.
Awasthi 2006 {published data only}
  • Awasthi S, INCLEN Childnet Zinc Effectiveness for Diarrhea (IC-ZED) Group. Zinc supplementation in acute diarrhea is acceptable, does not interfere with oral rehydration, and reduces the use of other medications: a randomized trial in five countries. Journal of Pediatric Gastroenterology and Nutrition 2006;42(3):300-5.
Baqui 2002 {published data only}
  • Baqui AH, Black RE, El Arifeen S, Yunus M, Chakraborty J, Ahmed S, et al. Effect of zinc supplementation started during diarrhoea on morbidity and mortality in Bangladeshi children: community randomised trial. BMJ 2002;325(7372):1059-64.
  • Baqui AH, Black RE, El Arifeen S, Yunus M, Zaman K, Begum N, et al. Zinc therapy for diarrhoea increased the use of oral rehydration therapy and reduced the use of antibiotics in Bangladeshi children. Journal of Health, Population, and Nutrition 2004;22(4):440-2.
Baqui 2003 {published data only}
  • Baqui AH, Zaman K, Persson LA, El Arifeen S, Yunus M, Begum N, et al. Simultaneous weekly supplementation of iron and zinc is associated with lower morbidity due to diarrhea and acute lower respiratory infection in Bangladeshi infants. Journal of Nutrition 2003;133(12):4150-7.
Baqui 2006 {published data only}
  • Baqui AH, Black RE, Fischer Walker CL, Arifeen S, Zaman K, Yunus M, et al. Zinc supplementation and serum zinc during diarrhea. Indian Journal of Pediatrics 2006;73(6):493-7.
Baum 2010 {published data only}
  • Baum MK, Lai S, Sales S, Page JB, Campa A. Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV-infected adults. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2010;50(12):1653-60. [PUBMED: 20455705]
Behrens 1990 {published data only}
Bhandari 2002 {published data only}
  • Bhandari N, Bahl R, Taneja S, Strand T, Molbak K, Ulvik RJ, et al. Substantial reduction in severe diarrheal morbidity by daily zinc supplementation in young north Indian children. Pediatrics 2002;109(6):e86.
Bhandari 2005 {published data only}
  • Bhandari N, Mazumder S, Taneja S, Dube B, Black RE, Fontaine O, et al. A pilot test of the addition of zinc to the current case management package of diarrhea in a primary health care setting. Journal of Pediatric Gastroenterology and Nutrition 2005;41(5):685-7.
Bhandari 2007 {published data only}
  • Bhandari N, Taneja S, Mazumder S, Bahl R, Fontaine O, Bhan MK. Adding zinc to supplemental iron and folic acid does not affect mortality and severe morbidity in young children. Journal of Nutrition 2007;137(1):112-7.
Bhandari 2008 {published data only}
  • Bhandari N, Mazumder S, Taneja S, Dube B, Agarwal RC, Mahalanabis D, et al. Effectiveness of zinc supplementation plus oral rehydration salts compared with oral rehydration salts alone as a treatment for acute diarrhea in a primary care setting: a cluster randomized trial. Pediatrics 2008;121(5):e1279-85.
Bhatnagar 2004b {published data only}
  • Bhatnagar S, Natchu UC. Zinc in child health and disease. Indian Journal of Pediatrics 2004;71(11):991-5.
Bhutta 2000a {published data only}
  • Bhutta ZA, Raza F, Nizami SQ, Issani Z. Does zinc supplementation influence appetite in malnourished children with persistent diarrhoea? A randomized controlled trial in Pakistan. Journal of Pediatric Gastroenterology and Nutrition 2000;31 Suppl 2:23.
Bilenko 2010 {published data only}
  • Bilenko N, Belmaker I, Vardi H, Fraser D. Efficacy of multiple micronutrient supplementations on child health: study design and baseline characteristics. The Israel Medical Association journal : IMAJ 2010;12(6):342-7.
Black 2001 {published data only}
Bobat 2005 {published data only}
  • Bobat R, Coovadia H, Stephen C, Naidoo KL, McKerrow N, Black RE, et al. Safety and efficacy of zinc supplementation for children with HIV-1 infection in South Africa: a randomised double-blind placebo-controlled trial. Lancet 2005;366(9500):1862-7.
Borges 2007 {published data only}
  • Borges Dantas CV, Veiga Black AP, Barroso dos Santos G, Jesus Oliveira EF, Serpa Barbosa RF, Moreira S, et al. Association among serum concentration of minerals, anthropometric indices and diarrhea in low-income children in the metropolitan region of Rio de Janeiro, Brazil [Associação entre concentrações séricas de minerais, índices antropométricos e ocorrência de diarréia entre crianças de baixa renda da região metropolitana do Rio de Janeiro]. Revista de Nutricao 2007;20(2):159-69.
Brooks 2005b {published data only}
  • Brooks WA, Santosham M, Naheed A, Goswami D, Wahed MA, Diener-West M, et al. Effect of weekly zinc supplements on incidence of pneumonia and diarrhoea in children younger than 2 years in an urban, low-income population in Bangladesh: randomised controlled trial. Lancet 2005;366(9490):999-1004.
Brown 2007 {published data only}
  • Brown KH, de Romana DL, Arsenault JE, Peerson JM, Penny ME. Comparison of the effects of zinc delivered in a fortified food or a liquid supplement on the growth morbidity and plasma zinc concentrations of young Peruvian children. American Journal of Clinical Nutrition 2007;85(2):538-47.
Brown 2007a {published data only}
  • Brown KH, Lopez de Romana D, Arsenault JE, Peerson JM, Penny ME. Comparison of the effects of zinc delivered in a fortified food or a liquid supplement on the growth, morbidity, and plasma zinc concentrations of young Peruvian children. The American Journal of Clinical Nutrition 2007;85(2):538-47.
Carbajal 2000 {published data only}
  • Carbajal C. Micronutrients: An option in the treatment of acute diarrheal diseases [Micronutrientes: una opción en el tratamiento de las enfermedades diarreicas agudas]. Revista Cubana de Pediatría 2000;72(4):261-6.
Carcamo 2006 {published data only}
  • Carcamo C, Hooton T, Weiss NS, Gilman R, Wener MH, Chavez V, et al. Randomized controlled trial of zinc supplementation for persistent diarrhea in adults with HIV-1 infection. Journal of Acquired Immune Deficiency Syndromes 2006;43(2):197-201.
Chandyo 2010 {published data only}
  • Chandyo RK, Shrestha PS, Valentiner-Branth P, Mathisen M, Basnet S, Ulak M, et al. Two weeks of zinc administration to Nepalese children with pneumonia does not reduce the incidence of pneumonia or diarrhea during the next six months. The Journal of Nutrition 2010;140(9):1677-82.
Chang 2010 {published data only}
  • Chang S, El Arifeen S, Bari S, Wahed MA, Rahman KM, Rahman MT, et al. Supplementing iron and zinc: double blind, randomized evaluation of separate or combined delivery. European Journal of Clinical Nutrition 2010;64(2):153-60.
Chen 2010 {published data only}
  • Chen K, Zhang X, Li TY, Chen L, Wei XP, Qu P, et al. Effect of vitamin A, vitamin A plus iron and multiple micronutrient-fortified seasoning powder on infectious morbidity of preschool children. Nutrition 2010, June 1;27(4):428-34.
Chhagan 2009 {published data only}
  • Chhagan MK, Van den Broeck J, Luabeya KK, Mpontshane N, Tucker KL, Bennish ML. Effect of micronutrient supplementation on diarrhoeal disease among stunted children in rural South Africa. European Journal of Clinical Nutrition 2009;63(7):850-7.
Chhagan 2010 {published data only}
  • Chhagan MK, Van den Broeck J, Luabeya KK, Mpontshane N, Tomkins A, Bennish ML. Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6-24 months. BMC Public Health 2010;10:145.
Christian 2009 {published data only}
  • Christian P, Stewart CP, LeClerq SC, Wu L, Katz J, West KP Jr, et al. Antenatal and postnatal iron supplementation and childhood mortality in rural Nepal: a prospective follow-up in a randomized, controlled community trial. American Journal of Epidemiology 2009;170(9):1127-36.
CIGNIS 2010 {published data only}
  • The Chilenje Infant Growth, Nutrition and Infection (CIGNIS) Study Team. Micronutrient fortification to improve growth and health of maternally HIV-unexposed and exposed Zambian infants: a randomised controlled trial. PLoS ONE 2010;5(6):e11165.
Cross 2009 {published data only}
  • Cross AJ, Heath AL, Ferguson EL, Gray AR, Szymlek-Gay EA. Rates of common communicable illnesses in non-anaemic 12-24 month old South Island, New Zealand children. The New Zealand Medical Journal 2009;122(1290):24-35.
Dhingra 2009 {published data only}
  • Dhingra U, Hiremath G, Menon VP, Dhingra P, Sarkar A, Sazawal S. Zinc deficiency: descriptive epidemiology and morbidity among preschool children in peri-urban population in Delhi, India. Journal of Health, Population, and Nutrition 2009;27(5):632-9.
Doherty 1998 {published data only}
  • Doherty CP, Sarkar MA, Shakur MS, Ling SC, Elton RA, Cutting WA. Zinc and rehabilitation from severe protein-energy malnutrition: higher-dose regimens are associated with increased mortality. American Journal of Clinical Nutrition 1998;68(3):742-8.
Ebrahimi 2006 {published data only}
  • Ebrahimi S, Pormahmodi A, Kamkar A. Study of zinc supplementation on growth of schoolchildren in Yasuj, Southwest of Iran. Pakistan Journal of Nutrition 2006;5(4):341-2.
Ellis 2007 {published data only}
  • Ellis AA, Winch P, Daou Z, Gilroy KE, Swedberg E. Home management of childhood diarrhoea in southern Mali-Implications for the introduction of zinc treatment. Social Science and Medicine 2007;64(3):701-12.
Ferraz 2007 {published data only}
  • Ferraz IS, Daneluzzi JC, Vannucchi H, Jordão Jr AA, Ricco RG, Del Ciampo LA, Martinelli CE Jr, Engelberg AA, Bonilha LR, Custódio VI. Zinc serum levels and their association with vitamin A deficiency in preschool children [Nível sérico de zinco e sua associação com deficiência de vitamina A em crianças pré-escolares]. Jornal de Pediatria (Rio J) 2007;83(6):512-17.
Ferrufino 2007 {unpublished data only}
  • Ferrufino B, Sagrario A. Acceptability of mothers of zinc sulphate supplementation in children under 5 years in the municipality of Jinotega. November 2006 to March 2007. [Aceptabilidad de las madres de la suplementación del sulfato de zinc en el manejo de las enfermedades diarreicas en menores de 5 años, municipio de Jinotega. Noviembre del año 2006 a marzo del año 2007]. Thesis, Universidad Nacional Autónoma de Nicaragua, Managua, 2007.
Fischer Walker 2008 {published data only}
  • Fischer Walker CL, Black RE, Baqui AH. Does age affect the response to zinc therapy for diarrhoea in Bangladeshi infants?. Journal of Health, Population, and Nutrition 2008;26(1):105-9.
Gardner 2005 {published data only}
  • Gardner JM, Powell CA, Baker-Henningham H, Walker SP, Cole TJ, Grantham-McGregor SM. Zinc supplementation and psychosocial stimulation: effects on the development of undernourished Jamaican children. American Journal of Clinical Nutrition 2005;82(2):399-405.
Garenne 2007 {published data only}
  • Garenne M, Becher H, Ye Y, Kouyate B, Muller O. Sex-specific responses to zinc supplementation in Nouna, Burkina Faso. Journal of Pediatric Gastroenterology and Nutrition 2007;44(5):619-28.
Gregorio 2007 {published data only}
Gupta 2003 {published data only}
  • Gupta DN, Mondal SK, Ghosh S, Rajendran K, Sur D, Manna B. Impact of zinc supplementation on diarrhoeal morbidity in rural children of West Bengal, India. Acta Paediatrica 2003;92(5):531-6.
    Direct Link:
Gupta 2007 {published data only}
  • Gupta DN, Rajendran K, Mondal SK, Ghosh S, Bhattacharya SK. Operational feasibility of implementing community-based zinc supplementation:impact on childhood diarrheal morbidity. Pediatric Infectious Disease Journal 2007;26(4):306-10.
Heinig 2006 {published data only}
  • Heinig MJ, Brown KH, Lonnerdal B, Dewey KG. Zinc supplementation does not affect growth morbidity or motor development of US term breastfed infants at 4-10 mo of age. American Journal of Clinical Nutrition 2006;84(3):594-601.
Hettiarachchi 2008 {published data only}
  • Hettiarachchi M, Liyanage C, Wickremasinghe R, Hilmers DC, Abrams SA. The efficacy of micronutrient supplementation in reducing the prevalence of anaemia and deficiencies of zinc and iron among adolescents in Sri Lanka. European Journal of Clinical Nutrition 2008;62(7):856-65.
Hidayat 1998 {published data only}
  • Hidayat A, Achadi A, Sunoto, Soedarmo SP. The effect of zinc supplementation in children under three years of age with acute diarrhea in Indonesia. Medical Journal of Indonesia 1998;7:237–41.
Hoque 2006 {published data only}
Hyder 2007 {published data only}
  • Hyder SM, Haseen F, Khan M, Schaetzel T, Jalal CS, Rahman M, et al. A multiple-micronutrient-fortified beverage affects hemoglobin, iron, and vitamin A status and growth in adolescent girls in rural Bangladesh. The Journal of Nutrition 2007;137(9):2147-53.
Iannotti 2010 {published data only}
  • Iannotti LL, Zavaleta N, Leon Z, Huasquiche C, Shankar AH, Caulfield LE. Maternal zinc supplementation reduces diarrheal morbidity in peruvian infants. The Journal of Pediatrics 2010;156(6):960-4, 964.e1-2.
Islam 2010 {published data only}
Jimenez 2000 {published data only}
  • Jimenez R, Sagaro E, Lafita Y. How growth infants supplemented with zinc sulfate after an episode of persistent diarrhea. Journal of Pediatric Gastroenterology and Nutrition 2000;31 Suppl 2:26.
Kelly 1999 {published data only}
  • Kelly P, Musonda R, Kafwembe E, Kaetano L, Keane E, Farthing M. Micronutrient supplementation in the AIDS diarrhoea-wasting syndrome in Zambia: a randomized controlled trial. AIDS 1999;13(4):495-500.
Kelly 2010 {published data only}
  • Kelly P, Shawa T, Mwanamakondo S, Soko R, Smith G, Barclay GR, et al. Gastric and intestinal barrier impairment in tropical enteropathy and HIV: limited impact of micronutrient supplementation during a randomised controlled trial. BMC Gastroenterology 2010;10:72.
Larson 2010 {published data only}
  • Larson CP, Nasrin D, Saha A, Chowdhury MI, Qadri F. The added benefit of zinc supplementation after zinc treatment of acute childhood diarrhoea: a randomized, double-blind field trial. Tropical Medicine and International Health 2010;15(6):754-61.
    Direct Link:
Lin 2008 {published data only}
  • Lin CA, Manary MJ, Maleta K, Briend A, Ashorn P. An energy-dense complementary food is associated with a modest increase in weight gain when compared with a fortified porridge in Malawian children aged 6-18 months. The Journal of Nutrition 2008;138(3):593-8.
Lind 2004 {published data only}
  • Lind T, Lonnerdal B, Stenlund H, Gamayanti IL, Ismail D, Seswandhana R, et al. A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: effects on growth and development. American Journal of Clinical Nutrition 2004;80(3):729-36.
Lind 2008 {published data only}
  • Lind T, Seswandhana R, Persson LA, Lonnerdal B. Iron supplementation of iron-replete Indonesian infants is associated with reduced weight-for-age. Acta paediatrica 2008;97(6):770-5.
    Direct Link:
Lira 1998 {published data only}
  • Lira PI, Ashworth A, Morris SS. Effect of zinc supplementation on the morbidity, immune function, and growth of low-birth-weight, full-term infants in northeast Brazil. American Journal of Clinical Nutrition 1998;68 Suppl 2:418s-24s.
Long 2006 {published data only}
  • Long KZ, Montoya Y, Hertzmark E, Santos JI, Rosado JL. A double-blind, randomized, clinical trial of the effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections in children in Mexico City, Mexico. American Journal of Clinical Nutrition 2006;83(3):693-700.
Long 2007 {published data only}
  • Long KZ, Rosado JL, Montoya Y, de Lourdes Solano M, Hertzmark E, DuPont HL, et al. Effect of vitamin A and zinc supplementation on gastrointestinal parasitic infections among Mexican children. Pediatrics 2007;120(4):e846-55.
Lopez 2005 {published data only}
  • Lopez de Romana G, Cusirramos S, Lopez de Romana D, Gross R. Efficacy of multiple micronutrient supplementation for improving anemia, micronutrient status, growth, and morbidity of Peruvian infants. Journal of Nutrition 2005;135(3):646-52.
Luabeya 2007 {published data only}
  • Luabeya KK, Mpontshane N, Mackay M, Ward H, Elson I, Chhagan M, et al. Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial. PLoS ONE 2007;2(6):e541.
Lukacik 2008 {published data only}
Makonnen 2003a {published data only}
  • Makonnen B, Venter A, Joubert G. A randomized controlled study of the impact of dietary zinc supplementation in the management of children with protein-energy malnutrition in Lesotho. I: Mortality and morbidity. Journal of Tropical Pediatrics 2003;49(6):340-52.
Makonnen 2003b {published data only}
  • Makonnen B, Venter A, Joubert G. A randomized controlled study of the impact of dietary zinc supplementation in the management of children with protein-energy malnutrition in Lesotho. II: Special investigations. Journal of Tropical Pediatrics 2003;49(6):353-60.
Manger 2008 {published data only}
  • Manger MS, McKenzie JE, Winichagoon P, Gray A, Chavasit V, Pongcharoen T, et al. A micronutrient-fortified seasoning powder reduces morbidity and improves short-term cognitive function, but has no effect on anthropometric measures in primary school children in northeast Thailand: a randomized controlled trial. The American Journal of Clinical Nutrition 2008;87(6):1715-22.
Mazariegos 2010 {published data only}
  • Mazariegos M, Hambidge KM, Westcott JE, Solomons NW, Raboy V, Das A, et al. Neither a zinc supplement nor phytate-reduced maize nor their combination enhance growth of 6- to 12-month-old Guatemalan infants. The Journal of Nutrition 2010;140(5):1041-8.
Mazumder 2010 {published data only}
  • Mazumder S, Taneja S, Bhandari N, Dube B, Agarwal RC, Mahalanabis D, et al. Effectiveness of zinc supplementation plus oral rehydration salts for diarrhoea in infants aged less than 6 months in Haryana state, India. Bulletin of the World Health Organization 2010;88(10):754-60.
Mda 2010 {published data only}
  • Mda S, van Raaij JM, de Villiers FP, MacIntyre UE, Kok FJ. Short-term micronutrient supplementation reduces the duration of pneumonia and diarrheal episodes in HIV-infected children. The Journal of Nutrition 2010;140(5):969-74.
Meeks 1998 {published data only}
  • Meeks Gardner J, Witter MM, Ramdath DD. Zinc supplementation: effects on the growth and morbidity of undernourished Jamaican children. European Journal of Clinical Nutrition 1998;52(1):34-9.
Müller 2001 {published data only}
  • Müller O, Becher H, van Zweeden AB, Ye Y, Diallo DA, Konate AT, et al. Effect of zinc supplementation on malaria and other causes of morbidity in west African children: randomised double blind placebo controlled trial. BMJ 2001;322(7302):1567.
Naheed 2009 {published data only}
  • Naheed A, Walker Fischer CL, Mondal D, Ahmed S, Arifeen SE, Yunus M, et al. Zinc therapy for diarrhoea improves growth among Bangladeshi infants 6 to 11 months of age. Journal of Pediatric Gastroenterology and Nutrition 2009;48(1):89-93.
Nasrin 2005 {published data only}
  • Nasrin D, Larson CP, Sultana S, Khan TU. Acceptability of and adherence to dispersible zinc tablet in the treatment of acute childhood diarrhoea. Journal of Health, Population, and Nutrition 2005;23(3):215-21.
Nga 2009 {published data only}
  • Nga TT, Winichagoon P, Dijkhuizen MA, Khan NC, Wasantwisut E, Furr H, et al. Multi-micronutrient-fortified biscuits decreased prevalence of anemia and improved micronutrient status and effectiveness of deworming in rural Vietnamese school children. The Journal of Nutrition 2009;139(5):1013-21.
Osendarp 2002 {published data only}
  • Osendarp SJ, Santosham M, Black RE, Wahed MA, van Raaij JM, Fuchs GJ. Effect of zinc supplementation between 1 and 6 mo of life on growth and morbidity of Bangladeshi infants in urban slums. American Journal of Clinical Nutrition 2002;76(6):1401-8.
Ouedraogo 2008 {published data only}
  • Ouedraogo HZ, Dramaix-Wilmet M, Zeba AN, Hennart P, Donnen P. Effect of iron or multiple micronutrient supplements on the prevalence of anaemia among anaemic young children of a malaria-endemic area: a randomized double-blind trial. Tropical Medicine and International Health 2008;13(10):1257-66.
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Passariello 2010 {published data only}
  • Passariello A, Terrin G, De Marco G, Cecere G, Ruotolo S, Marino A, et al. Efficacy of a New Hypotonic Oral Rehydration Solution Containing Zinc and Prebiotics in the Treatment of Childhood Acute Diarrhea: A Randomized Controlled Trial. The Journal of Pediatrics 2011;158(2):288-92.e1.
Patel 2005 {published data only}
  • Patel AB, Dhande LA, Rawat MS. Therapeutic evaluation of zinc and copper supplementation in acute diarrhea in children: double blind randomized trial. Indian Pediatrics 2005;42(5):433-42.
Patel 2010 {published data only}
  • Patel AB, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Influence of zinc supplementation in acute diarrhea differs by the isolated organism. International Journal of Pediatrics 2010;2010:671587.
Patel 2010a {published data only}
Patro 2008 {published data only}
Penny 2004a {published data only}
  • Penny ME, Marin RM, Duran A, Peerson JM, Lanata CF, Lonnerdal B, et al. Randomized controlled trial of the effect of daily supplementation with zinc or multiple micronutrients on the morbidity, growth, and micronutrient status of young Peruvian children. American Journal of Clinical Nutrition 2004;79(3):457-65.
Penny 2004b {published data only}
Polat 2006 {published data only}
Rahman 2001 {published data only}
  • Rahman MM, Vermund SH, Wahed MA, Fuchs GJ, Baqui AH, Alvarez JO. Simultaneous zinc and vitamin A supplementation in Bangladeshi children: randomised double blind controlled trial. BMJ 2001;323(7308):314-8.
Rahman 2005 {published data only}
  • Rahman MJ, Sarker P, Roy SK, Ahmad SM, Chisti J, Azim T, et al. Effects of zinc supplementation as adjunct therapy on the systemic immune responses in shigellosis. American Journal of Clinical Nutrition 2005;81(2):495-502.
Raqib 2004 {published data only}
  • Raqib R, Roy SK, Rahman MJ, Azim T, Ameer SS, Chisti J, et al. Effect of zinc supplementation on immune and inflammatory responses in pediatric patients with shigellosis. American Journal of Clinical Nutrition 2004;79(3):444-50.
Richard 2006 {published data only}
  • Richard SA, Zavaleta N, Caulfield LE, Black RE, Witzig RS, Shankar AH. Zinc and iron supplementation and malaria, diarrhea, and respiratory infections in children in the Peruvian Amazon. American Journal of Tropical Medicine and Hygiene 2006;75(1):126-32.
Rollins 2007 {published data only}
  • Rollins NC, van den Broeck J, Kindra G, Pent M, Kasambira T, Bennish ML. The effect of nutritional support on weight gain of HIV-infected children with prolonged diarrhoea. Acta paediatrica 2007;96(1):62-8.
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Rosado 1997 {published data only}
  • Rosado JL, Lopez P, Munoz E, Martinez H, Allen LH. Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers. American Journal of Clinical Nutrition 1997;65(1):13-9.
Rosado 1998 {published data only}
Rosado 2009 {published data only}
  • Rosado JL, Caamano MC, Montoya YA, de Lourdes Solano M, Santos JI, Long KZ. Interaction of zinc or vitamin A supplementation and specific parasite infections on Mexican infants' growth: a randomized clinical trial. European Journal of Clinical Nutrition 2009;63(10):1176-84.
Roy 1992 {published data only}
  • Roy SK, Akramuzzaman SM, Haider R, Mahalanabis D, Behrens RH, Wahed MA, et al. Zinc supplementation in diarrhoea: Nutritional implication on clinical recovery and intestinal permeability [Abstract]. Journal of Gastroenterology and Hepatology 1994;9(6):A166.
  • Roy SK, Behrens RH, Haider R, Akramuzzaman SM, Mahalanabis D, Wahed MA, et al. Impact of zinc supplementation on intestinal permeability in Bangladeshi children with acute diarrhoea and persistent diarrhoea syndrome. Journal of Pediatric Gastroenterology and Nutrition 1992;15(3):289-96.
Roy 1999 {published data only}
  • Roy SK, Tomkins AM, Haider R, Behren RH, Akramuzzaman SM, Mahalanabis D, et al. Impact of zinc supplementation on subsequent growth and morbidity in Bangladeshi children with acute diarrhoea. European Journal of Clinical Nutrition 1999;53(7):529-34.
Roy 2007 {published data only}
  • Roy SK, Tomkins AM, Akramuzzaman SM, Chakraborty B, Ara G, Biswas R, et al. Impact of zinc supplementation on subsequent morbidity and growth in Bangladeshi children with persistent diarrhoea. Journal of Health, Population, and Nutrition 2007;25(1):67-74.
Roy 2008a {published data only}
Ruel 1997 {published data only}
  • Ruel MT, Rivera JA, Santizo MC, Lonnerdal B, Brown KH. Impact of zinc supplementation on morbidity from diarrhea and respiratory infections among rural Guatemalan children. Pediatrics 1997;99(6):808-13.
Sabatier 1997 {published data only}
  • Sabatier García FJ, Izquierdo Estévez A, León García RE, Díaz Fernández L. Benefits of zinc in the treatment of infants presenting with diarrhea [Beneficios del cinc en el tratamiento de niños con diarrea]. Revista Cubana de Pediatría 1997;69(3/4):197-200.
Samuel 1995 {published data only}
  • Samuel MJ. Paediatrics Forum. Acute diarrhoea. Africa Health 1995;17(5):27, 29-30.
Sancho Martinez 2007 {published data only}
  • Sancho Martinez A, Saenz De Pipaon Marcos M, Quero Jimenez J. Effects of supplementation with zinc in the first year of life [Efectos de la suplementacion con cinc en el primer ano de vida]. Revista Espanola De Pediatria 2007;63(6):464-82.
Sazawal 1996 {published data only}
  • Sazawal S, Black RE, Bhan MK, Jalla S, Bhandari N, Sinha A, et al. Zinc supplementation reduces the incidence of persistent diarrhea and dysentery among low socio-economic children in India. Journal of Nutrition 1996;126(2):443-50.
Sazawal 1997a {published data only}
  • Sazawal S, Black RE, Bhan MK, Jalla S, Sinha A, Bhandari N. Efficacy of zinc supplementation in reducing the incidence and prevalence of acute diarrhea - a community-based, double-blind, controlled trial. American Journal of Clinical Nutrition 1997;66(2):413-8.
Sazawal 2004a {published data only}
  • Sazawal S, Marwah D, Sazawal S, Black RE, Deb S, Dhingra U, et al. Efficacy of zinc and iron fortification of milk in prevention of anemia, diarrhea pneumonia, and iron deficiency- a community based double masked randomized trial. Journal of Pediatric Gastroenterology and Nutrition 2004;39 Suppl 1:417-8.
Sazawal 2007a {published data only}
  • Sazawal S, Dhingra U, Dhingra P, Hiremath G, Kumar J, Sarkar A, et al. Effects of fortified milk on morbidity in young children in north India: community based randomised double masked placebo controlled trial. BMJ 2007;334(7585):140.
Sazawal 2007b {published data only}
  • Sazawal S, Dhingra U, Deb S, Bhan MK, Menon VP, Black RE. Effect of zinc added to multi-vitamin supplementation containing low-dose vitamin A on plasma retinol level in children--a double-blind randomized, controlled trial. Journal of Health, Population, and Nutrition 2007;25(1):62-6.
Sazawal 2007c {published data only}
  • Sazawal S, Black RE, Ramsan M, Chwaya HM, Dutta A, Dhingra U, et al. Effect of zinc supplementation on mortality in children aged 1-48 months: a community-based randomised placebo-controlled trial. Lancet 2007;369(9565):927-34.
Shamir 2005 {published data only}
  • Shamir R, Makhoul IR, Etzioni A, Shehadeh N. Evaluation of a diet containing probiotics and zinc for the treatment of mild diarrheal illness in children younger than one year of age. Journal of the American College of Nutrition 2005;24(5):370-5.
Shankar 1998 {published data only}
  • Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection. American Journal Clinical Nutrition 1998;68 Suppl 2:447-63.
Sharieff 2006 {published data only}
  • Sharieff W, Bhutta Z, Schauer C, Tomlinson G, Zlotkin S. Micronutrients (including zinc) reduce diarrhoea in children: the Pakistan Sprinkles Diarrhoea Study. Archives of Disease in Childhood 2006;91(7):573-9.
Sheikh 2010 {published data only}
  • Sheikh A, Shamsuzzaman S, Ahmad SM, Nasrin D, Nahar S, Alam MM, et al. Zinc influences innate immune responses in children with enterotoxigenic Escherichia coli-induced diarrhea. The Journal of Nutrition 2010;140(5):1049-56.
Sur 2003 {published data only}
  • Sur D, Gupta DN, Mondal SK, Ghosh S, Manna B, Rajendran K, et al. Impact of zinc supplementation on diarrheal morbidity and growth pattern of low birth weight infants in Kolkata, India: a randomized, double-blind, placebo-controlled, community-based study. Pediatrics 2003;112(6 Pt 1):1327-32.
Taneja 2009 {published data only}
  • Taneja S, Bhandari N, Rongsen-Chandola T, Mahalanabis D, Fontaine O, Bhan MK. Effect of zinc supplementation on morbidity and growth in hospital-born, low-birth-weight infants. The American Journal of Clinical Nutrition 2009;90(2):385-91.
Taneja 2010 {published data only}
  • Taneja S, Strand TA, Sommerfelt H, Bahl R, Bhandari N. Zinc supplementation for four months does not affect growth in young north Indian children. The Journal of Nutrition 2010;140(3):630-4.
Tielsch 2006 {published data only}
  • Tielsch JM, Khatry SK, Stoltzfus RJ, Katz J, LeClerq SC, Adhikari R, et al. Effect of routine prophylactic supplementation with iron and folic acid on preschool child mortality in southern Nepal: community-based, cluster-randomised, placebo-controlled trial. Lancet 2006;367(9505):144-52.
Tielsch 2007 {published data only}
  • Tielsch JM, Khatry SK, Stoltzfus RJ, Katz J, LeClerq SC, Adhikari R, et al. Effect of daily zinc supplementation on child mortality in southern Nepal: a community-based, cluster randomised, placebo-controlled trial. Lancet 2007;370(9594):1230-9.
Umeta 2000 {published data only}
Untoro 2005 {published data only}
  • Untoro J, Karyadi E, Wibowo L, Erhardt MW, Gross R. Multiple micronutrient supplements improve micronutrient status and anemia but not growth and morbidity of Indonesian infants: a randomized, double-blind, placebo-controlled trial. Journal of Nutrition 2005;135 Suppl(3):639-45.
Valery 2005 {published data only}
  • Valery PC, Torzillo PJ, Boyce NC, White AV, Stewart PA, Wheaton GR, et al. Zinc and vitamin A supplementation in Australian Indigenous children with acute diarrhoea: a randomised controlled trial. Medical Journal of Australia 2005;182(10):530-5.
Walden 2004 {published data only}
Walker 2007 {published data only}
  • Walker CL, Bhutta ZA, Bhandari N, Teka T, Shahid F, Taneja S, et al. Zinc during and in convalescence from diarrhea has no demonstrable effect on subsequent morbidity and anthropometric status among infants <6 mo of age. American Journal of Clinical Nutrition 2007;85(3):887-94.
Wieringa 2010 {published data only}
  • Wieringa FT, Dijkhuizen MA, Muhilal, Van der Meer JW. Maternal micronutrient supplementation with zinc and beta-carotene affects morbidity and immune function of infants during the first 6 months of life. European Journal of Clinical Nutrition 2010;64(10):1072-9.
Winch 2006 {published data only}
  • Winch PJ, Gilroy KE, Doumbia S, Patterson AE, Daou Z, Coulibaly S, et al. Prescription and administration of a 14-day regimen of zinc treatment for childhood diarrhea in Mali. American Journal of Tropical Medicine and Hygiene 2006;74(5):880-3.
Winch 2008 {published data only}
  • Winch PJ, Gilroy KE, Doumbia S, Patterson AE, Daou Z, Diawara A, et al. Operational issues and trends associated with the pilot introduction of zinc for childhood diarrhoea in Bougouni district, Mali. Journal of Health, Population, and Nutrition 2008;26(2):151-62.
Wuehler 2008 {published data only}
  • Wuehler SE, Sempertegui F, Brown KH. Dose-response trial of prophylactic zinc supplements, with or without copper, in young Ecuadorian children at risk of zinc deficiency. The American Journal of Clinical Nutrition 2008;87(3):723-33.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
NCT01140074 {unpublished data only}
  • Efficacy of Zinc Sulfate With Probiotics for the Treatment of Acute diarrhoea in Children. Ongoing study July 2010 (not yet recruiting in December 2010).
NCT01198587 {unpublished data only}
  • A Double Blind Randomized Placebo Controlled Trial of Oral Zinc for Children With Acute diarrhoea in a Developed Nation.. Ongoing study September 2010.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Albert 2003
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Berni Canani 2010
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Beshgetoor 1998
Bhutta 2000b
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Bhutta 2008
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Brown 2003
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Dijkhuizen 2001
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Fischer Walker 2005
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Fontaine 2001
Garenne 2005
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Hoque 2005
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Hoque 2009
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Iqbal 2001
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Wagstaff 2004
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WHO/UNICEF 2004
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Zlotkin 2003
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References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Lazzerini 2005
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