Zinc & Vitamin A: Mitigating Diarrhea in Children
Zinc treatment and other micronutrients. Treatment of diarrheal disease with zinc supplementation can reduce the severity and duration of diarrhea episodes. It may also prevent future episodes for up to three months. Other micronutrients, particularly vitamin A, are also important in controlling severe episodes.
Zinc Treatment and Other Micronutrients
Problem. Zinc, an important micronutrient that is needed for the overall health and development of infants and young children, can become depleted through diarrhea.
Solution. Zinc is a critical new intervention for treating diarrhea, particularly in the developing world. It is a safe and effective treatment option that can considerably reduce the duration and severity of diarrhea episodes, decrease stool output, and lessen the need for hospitalization. It may also prevent future diarrhea for up to three months. It has been determined that the use of both zinc and ORS for diarrhea can dramatically reduce the need for unscheduled IV therapy and, more importantly, reduce the number of diarrheal disease-related deaths.
Zinc can be administered as syrup or a tablet that is dissolved in clean water or breast milk. When using zinc to treat diarrheal disease, it is important that the full course of zinc is taken in conjunction with ORS/ORT and that follow-up and behavior change messages for caregivers are given to ensure full compliance.
Zinc Treatment Results In:
5% reduction in duration of acute diarrhea
29% reduction in duration of persistent diarrhea
40% reduction in treatment failure or death from persistent diarrhea 51
Impact. In 2004, the WHO and UNICEF issued a joint statement recommending the use of a 10- to 14-day zinc treatment in conjunction with low-osmolarity ORS as a two-pronged approach to treat acute diarrhea in children.
Vitamin A
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 6 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.52
“Looking forward, the large-scale introduction of pneumococcal and rotavirus vaccines in developing countries will provide us with an historic opportunity to address two of the most important causes of mortality in children under five — pneumonia and diarrhea — in a comprehensive way...a focus on ORT, vitamin A, and zinc; community-case management of diarrhea and pneumonia; social and behavior change, including promotion of early and exclusive breastfeeding; hand-washing with soap; and home-treatment of water; as well as community sanitation approaches. By introducing these new vaccines as part of a comprehensive package of services and strengthening community-based systems, we will maximize their impact on MDG 4, and do so in a sustainable way.” — Saad Houry, Deputy Executive Director of UNICEF.55
Conclusion
Prioritizing the implementation of an appropriate combination of interventions against diarrhea, including improved water, hygiene, and sanitation; optimal infant and young child feeding; increased access to and uptake of vitamin A, ORS, and zinc; and rotavirus vaccination.
Adapted from:
Diarrheal disease: Solutions to Defeat a Global Killer
Path
http://www.eddcontrol.org/files/Solutions_to_Defeat_a_Global_Killer.pdf