title: Zinc and copper supplementation are not cost-effective interventions in the treatment of acute diarrhea.
abstract: BACKGROUND
  Diarrhea is one of the principal causes of morbidity and mortality among children in the developing world. Cumulative costs of treating diarrhea would be high and would further increase if zinc was used as an adjunct to treatment of acute diarrhea.
  
  
  OBJECTIVE
  To determine the impact of zinc supplementation on the mean predicted costs of treating acute diarrhea and the incremental cost-effectiveness (CE) as compared with placebo, from the provider's (government) and patient's perspective.
  
  
  METHODS
  In a randomized, double-blind, placebo-controlled clinical trial, 808 children aged 6-59 months with acute diarrhea were individually randomized to placebo (Pl), zinc (Zn) only, and zinc and copper (Zn + Cu) together with standard treatment of acute diarrhea. The actual resource utilization and cost data were collected for all participants. The incremental CE ratio and its 95% confidence interval (95% CI) were assessed.
  
  
  RESULTS
  The relative CE for treating acute diarrhea was 1.5 (95% CI: 1.50, 1.52) times more when supplemented with zinc and 1.7 (95% CI: 1.69, 1.71) times more when supplemented with Zn + Cu with no additional beneficial effect.
  
  
  CONCLUSIONS
  This study showed that zinc or zinc with copper supplementation were not cost-effective in the treatment of acute diarrhea in this study population.
authors.affiliation: Lata Medical Research Foundation, 9/1 Vasant Nagar, Nagpur 440 022, India. dr_apatel@yahoo.com
authors.forename: Archana B
authors.initials: AB
authors.lastname: Patel
authors.forename: Neetu
authors.initials: N
authors.lastname: Badhoniya
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dibley
mesh_terms: D000930:Antidiarrheals / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D003300:Copper / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003967:Diarrhea / Q000188:drug therapy*; D003968:Diarrhea, Infantile / Q000188:drug therapy; D004311:Double-Blind Method; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome; D015032:Zinc / Q000627:therapeutic use*
chemical_list: D000930:Antidiarrheals; D003300:Copper; D015032:Zinc