title: Zinc supplementation in young children: A review of the literature focusing on diarrhoea prevention and treatment.
abstract: OBJECTIVE
  It is estimated that zinc deficiency is responsible for 4.4% of childhood deaths in Africa, Asia, and Latin America. This review examines the impact of zinc supplementation, administered prophylactically or therapeutically, on diarrhoea.
  
  
  METHODS
  Relevant published articles were identified through systematic searches of electronic databases. Bibliographies of retrieved articles were examined.
  
  
  RESULTS
  A total of 38 studies were included in this review, 29 studies examined the effect of prophylactic zinc and nine studies examined the effects of therapeutic use of zinc for treatment of diarrhoea in children under five years.
  
  
  CONCLUSIONS
  Prophylactic zinc has been shown to be effective in decreasing both prevalence and incidence of diarrhoea, reducing respiratory infections and improving growth in children with impaired nutritional status. There is less conclusive evidence of reduction in diarrhoea duration or diarrhoea severity. While prophylactic zinc decreases mortality due to diarrhoea and pneumonia, it has not been shown to affect overall mortality. Therapeutic use of zinc for the treatment of diarrhoea in children has been shown to reduce diarrhoea incidence, stool frequency and diarrhoea duration as well as respiratory infections in zinc deficient children. However, stool output is only reduced in children with cholera. Less conclusive evidence exists for therapeutic zinc reducing mortality due to diarrhoea and respiratory infections. Specific definitions of diarrhoea severity, respiratory infection in further studies as well as examination of prophylactic zinc effectiveness in diarrhoea duration and severity effectiveness of therapeutic zinc in reducing mortality due to diarrhoea and respiratory infections are warranted.
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia. Electronic address: selma.liberato@menzies.edu.au.
authors.forename: Selma C
authors.initials: SC
authors.lastname: Liberato
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
authors.forename: Gurmeet
authors.initials: G
authors.lastname: Singh
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Kim
authors.initials: K
authors.lastname: Mulholland
mesh_terms: D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000178:diet therapy* / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009752:Nutritional Status / Q000187:drug effects; D012141:Respiratory Tract Infections / Q000178:diet therapy* / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome; D015032:Zinc / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D015032:Zinc
keywords: Diarrhoea; Growth; Oral zinc; Respiratory infection; Zinc deficiency