Zinc is very essential for physiological processes that include defense against several infections. Deficiency of zinc is accountable for almost 4% of child morbidity and mortality globally. Zinc supplements are to be given for 10-14 days along with low-osmolarity oral rehydration solution (Lo-ORS) and are also recommended for the treatment of diarrhea in children.

In children, who are aged ≥ 6 months, daily zinc supplements have shown to reduce the duration of acute diarrhea episodes by 12 hours and persistent diarrhea by 17 hours. Zinc supplements can reduce diarrhea mortality in children between ages 12 and 59 months by 23%. These are very safe but could be associated with an increase in vomiting, particularly with the first dose.

Heterogeneity between the outcomes of trials is not clearly understood but could be associated with dose along with the etiology of the diarrhea infection. Procurement problems have been overcome and the biggest challenge is changing the healthcare provider and caregiver approaches to management of diarrhea.

A few trials have been conducted of zinc adjunct treatment in severe respiratory tract infections and there is still insufficient evidence to recommend the addition of zinc therapy to antibiotic therapy. Daily zinc supplements for children >12 months of age in zinc deficient populations are expected to reduce diarrhea prevalence by 11-23%. The biggest impact is in decreasing several episodes of diarrhea. The effect on duration of diarrheal episodes is less evident, but could be up to 9% reduction. Zinc is effective in reducing dysentery and also persistent diarrhea. Zinc supplements can also prevent pneumonia by approximately 19%; however, heterogeneity in studies has not been explained.

Analyses that are limited to better quality studies using CHERG (Child Health Epidemiology Reference Group) methodology have revealed that zinc supplements are projected to reduce diarrheal deaths by 13% and pneumonia deaths by almost 20%. To combat childhood zinc deficiency, national-level programs must be accelerated.

Source: Penny ME. Zinc supplementation in public health. Ann Nutr Metab. 2013;62 Suppl 1:31-42. doi:10.1159/000348263