Serum zinc levels in acute diarrhoea and pneumonia in children aged 6 months to 6 years
Abstract
Background & Objectives: To compare serum zinc levels in children suffering from acute gastroenteritis, pneumonia (malnourished and normal) with a control group. To study the effects of zinc in reducing the frequency and duration of diarrhea and pneumonia & its impact on the further recurrence of these infections.
Methods: One hundred thirty (130) children in the age group of 6 months to 5 years were included. The Blood samples were drawn for zinc assay from all children at initial presentation and supplement with adjuvant oral zinc for 14 days. The duration of hospital stay and symptom resolution and the effect of supplementation over the next six months on these children was studied.
Results: The mean serum zinc levels were significantly lower in children with AGE and Pneumonia as compared to that of the children in the control group which was very highly significant (71.39, 69.45, 81.65 mcg/dl respectively). Also, the malnourished children in both the AGE & LRTI groups had a mean zinc level that was significantly lesser than the adequately nourished children (67.77:73.85 in the AGE group & 57.52: 75.62 in the LRTI group). In the follow-up period for six months, children with undernourishment and those who had low zinc levels at initial presentation had significantly more recurrences
Conclusions: Children with AGE and LRTI have a reduced serum zinc level when compared to controls. Zinc supplementation reduces the duration of symptoms in both AGE and LRTI children with low zinc levels and who were undernourished had frequent recurrences.
Downloads
References
2. Causes of death in neonates and children under five in the world (2016)". UNICEF, World Health Orga-nization. 2016.,
2. Shiffman J. Network advocacy and the emergence of global attention to newborn survival. Health Policy Plan. 2016; 31(1):i60-73. DOI: 10.1093/heapol/czv092. Epub 2015 .
3. Prasad AS. Zinc deficiency: Has been known of for 40 years but ignored by global health organisations. BMJ.2003;326(7386):409–410. DOI: 10.1136/bmj. 326. 7386.409
4. Bhutta ZA, Black RE, Brown KH, Gardner JM, Gore S, Hidayat A et al. Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: pooled analysis of randomized controlled trials. J Pediat. 1999;135(6):689-97.
5. Bresee JS, Duggan C, Glass RI, King CK. Managing acute gastroenteritis among children; oral rehydration, maintenance, and nutritional therapy. Am J Clin Nutr 2003; 52(RR16);1-16.
6. Brooks WA, Yunus M, Santosham M, Wahed MA, Nahar K, Yeasmin S, et al. Zinc for severe pneumonia in very young children: double-blind placebo-controlled trial. Lancet. 2004; 363 (9422):1683-8. DOI:10.1016/ S0140-6736(04)16252-1
7. Mahalanabis D, Lahiri M, Paul D, Gupta S, Gupta A, Wahed MA, et al. Randomized, double-blind, placebo-controlled clinical trial of the efficacy of treatment with zinc or vitamin A in infants and young children with severe acute lower respiratory infection. Am J Clin Nutr. 2004;79(3):430-6. DOI:10.1093/ajcn/ 79.3.430
8. Khalili B, Hart A, Mardani M, Khalili M, Mcardle F, Cuevas L. Diarrhea- associated micronutrient deficiencies and risk of subsequent diarrhea in admitted children to Hajar hospital in Shahrekord, Iran. Iranian J Clinic Infect Dis. 2007;2(3):121-128.
9. Black RE. Zinc deficiency, immune function, and morbidity and mortality from infectious disease among children in developing countries. Food Nut Bullet. 2001;22(2):155-62.DOI:10.1177/156482650102200205
10. Kumar S, Awasthi S, Jain A, Srivastava RC. Blood zinc levels in children hospitalized with severe pneumonia: a case control study. Indian Pediat. 2004;41 (5): 486-92.
11. Baqui AH, Black RE, El Arifeen S, Yunus M, Chakraborty J, Ahmed S, et al. Effect of zinc supplementation started during diarrhoea on morbidity and mortality in Bangladeshi children: community randomised trial. BMJ. 2002;325(7372):1059. DOI:10. 1136/bmj. 325.7372.1059
12. Olmez A, Yalçin SS, Yurdakök K, Coskun T. Serum zinc levels in children with acute gastroenteritis. PediatrInt.2007;49(3):314-7.DOI:10.1111/j.1442-200X. 2007. 02371.x
13. Dhingra U, Hiremath G, Menon VP, Dhingra P, Sarkar A, Sazawal S. Zinc deficiency: descriptive epidemiology and morbidity among preschool children in peri-urban population in Delhi, India. J Health, Populat, Nutri. 2009;27(5):632.
14. Tomkins A. Nutritional status and severity of diarrhoea among pre-school children in rural Nigeria. The Lancet. 1981; 317(8225): 860-2. DOI: https://doi. org/ 10. 1016/S0140-6736(81)92139-5
15. Caulfield LE, de Onis M, Blössner M, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. Am J Clin Nutr. 2004;80(1):193-8. DOI:10. 1093 / ajcn/80.1.193
16. Fishman SM, caulfield LE, De Onis M, Blossner M, Hyder AA, Mullany L, Black RE. Childhood and maternal underweight. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. 2004; 1:39-161
17. Polat TB, Uysalol M, Cetinkaya F. Efficacy of zinc supplementation on the severity and duration of diarrhea in malnourished Turkish children. Pediatr Int. 2003; 45(5):555-9. DOI: https://doi.org/10.1046/j. 1442-200X.2003.01772.x
18. Lazzerini M, Wanzira H., Oral zinc for treating diarrhea in children Cochrane Database Syst Rev. 2016 Dec 20; (12): CD005436. DOI: 10.1002/14651858. CD 00 5436.pub5
19. Devrajani BR, Shah SZ, Shaikh MA. Serum zinc level in patients with pneumonia: a six-month long cross-sectional descriptive study at Liaquat University Hospital Hyderabad, Sindh, Pakistan. Pakistan. J Pak Med Assoc. 2013;63(3):369-73.
Copyright (c) 2019 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.
OAI - Open Archives Initiative
