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

M. E. Penny, J. M. Peerson, R. M. Marin, A. Duran, C. F. Lanata, B. Lonnerdal, R. E. Black, K. H. Brown

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

Objective: To determine whether supplemental zinc, with or without additional micronutrients, affects the severity and duration of persistent childhood diarrhea and the rate of nutritional recovery. Design: The study was a community-based, double-blind, randomized trial implemented in a shanty town in Lima, Peru. Children aged 6 to 36 months with persistent (≥ 14 days) diarrhea received daily, for 2 weeks, a placebo (group P, n = 136) or a supplement of 20 mg of zinc, either with (group Z+VM, n = 157) or without (group Z, n = 139) additional vitamins and minerals. Symptoms of illness were recorded daily; and biochemical and anthropometric assessments were completed at baseline and on day 15. Results: The treatment groups were similar at baseline with regard to the characteristics of the presenting episode, anthropometric data, and plasma zinc concentration. The children consumed, on average, 95% (group P), 94% (group Z); or 88% (group Z+VM) of the supplement (P < .001). The plasma zinc concentration did not change significantly from baseline to clay 15 in group P (4 μg/dL) but increased by 38 μg/dL in group Z and 14 μg/dL in group Z+VM. The median duration of diarrhea after starting treatment was 1 day; among children who continued to have diarrhea, there was a significant effect of treatment on diarrheal duration (P = .04, analysis of covariance). Specifically, the duration of illness was significantly reduced by 28% in children in group Z (P = .01) and by 33% in girls in group Z+VM (P = .04). There were no differences in the severity of the episode by treatment group. Conclusion: There was a significant reduction in the duration of persistent diarrhea in selected subgroups of zinc-supplemented ambulatory patients in this population.

Original languageEnglish (US)
Pages (from-to)208-217
Number of pages10
JournalJournal of Pediatrics
Volume135
Issue number2 I
StatePublished - 1999
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Penny, M. E., Peerson, J. M., Marin, R. M., Duran, A., Lanata, C. F., Lonnerdal, B., Black, R. E., & Brown, K. H. (1999). 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, 135(2 I), 208-217.