Crowd outside of pharmacy building.

Greater community access to zinc could offer caregivers another option for treating and preventing severe diarrhea.

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Zinc treatment is a simple, inexpensive, and critical new tool for treating diarrheal episodes among children in the developing world. This important micronutrient becomes depleted during diarrhea, but recent studies suggest that replenishing zinc with a10- to 14-day course of treatment can reduce the duration and severity of diarrheal episodes and may also prevent future episodes for up to three months. It is important that the full-course of zinc is taken, and that follow-up and behavior change messages for caregivers are given to ensure full compliance.

In 2004, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) issued a joint statement regarding the clinical management of acute diarrhea. This statement recommended the use of zinc treatment, as well as a new formulation of oral rehydration solution (ORS), as a two-pronged approach to treatment.

Vitamin A supplementation is another important and low-cost intervention for controlling severe and potentially fatal diarrheal episodes. The relative risk of dying from diarrhea increases two-fold in children with vitamin A deficiency.  In countries where under-five mortality rates are high, giving semi-annual vitamin A supplements to children six to 59 months old decreases overall mortality from all childhood diseases by 23 percent and mortality from diarrhea by 32 percent. A dose of vitamin A for newborns has been found to be effective in reducing early mortality, and may soon be widely recommended.

Other micronutrients may be important to maintain the integrity of immune function and appetite during an episode of diarrhea. Iron deficiency, for example, depresses appetite and may increase the risk of malnutrition associated with diarrhea.

PATH is working with country partners to implement a comprehensive approach to diarrheal disease control that incorporates new technologies like zinc with proven interventions. For more information, please visit the PATH website.

UNICEF is helping countries with registration of zinc and collaborating with WHO to provide guidelines for its use in treating diarrhea.

Studies have shown that zinc treatment results in a 25 percent reduction in duration of acute diarrhea and a 40 percent reduction in treatment failure or death in persistent diarrhea.

Key resources

Below are some key documents on zinc. Please also browse our list of helpful websites for more resources.

Below is a key document on vitamin A.  Please also browse our list of helpful websites for more resources.

Other helpful websites

References

1Bhutta ZA, Bird SM, Black RE, et al. Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: Pooled analysis of randomized controlled trials. American Journal of Clinical Nutrition. 2000. 72(6):1516-1522.

Photo: PATH/Carib Nelson.