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International Journal of Pediatrics
Volume 2010, Article ID 671587, 9 pages
http://dx.doi.org/10.1155/2010/671587
Clinical Study

Influence of Zinc Supplementation in Acute Diarrhea Differs by the Isolated Organism

1NGO, Lata Medical Research Foundation, Nagpur 440022, India
2Department of Pediatrics, Indira Gandhi Government Medical College, Nagpur 440018, India
3The Sydney School of Public Health, University of Sydney, 2006 Sydney, Australia
4Department of Medicine/Infectious Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

Received 4 October 2009; Revised 6 February 2010; Accepted 14 March 2010

Academic Editor: Joseph M. Croffie

Copyright © 2010 Archana B. Patel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Zinc supplementation is recommended in all acute diarrheas in children from developing countries. We aimed to assess whether zinc supplementation would be equally effective against all the common organisms associated with acute diarrheas. We used data on 801 children with acute diarrhea recruited in a randomized, double blind controlled trial (ISRCTN85071383) of zinc and copper supplementation. Using prespecified subgroup analyses, multidimensionality reduction analyses, tests of heterogeneity, and stepwise logistic regression for tests of interactions, we found that the influence of zinc on the risk of diarrhea for more than 3 days depended on the isolated organism—beneficial in Klebsiella, neutral in Esherichia coli and parasitic infections, and detrimental in rotavirus coinfections. Although we found similar results for the outcome of high stool volume, the results did not reach statistical significance. Our findings suggest that the current strategy of zinc supplementation in all cases of acute diarrheas in children may need appropriate fine tuning to optimize the therapeutic benefit based on the causative organism, but further studies need to confirm and extend our findings.