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    Oral zinc supplementation for the treatment of acute diarrhea in children: a systematic review and meta-analysis.

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    Author
    Lamberti, LM; Walker, CLF; Chan, KY; Jian, W-Y; Black, RE
    Date
    2013-11-21
    Source Title
    Nutrients
    Publisher
    MDPI AG
    University of Melbourne Author/s
    Chan, Kit Yee
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Lamberti, L. M., Walker, C. L. F., Chan, K. Y., Jian, W. -Y. & Black, R. E. (2013). Oral zinc supplementation for the treatment of acute diarrhea in children: a systematic review and meta-analysis.. Nutrients, 5 (11), pp.4715-4740. https://doi.org/10.3390/nu5114715.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253131
    DOI
    10.3390/nu5114715
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847757
    Abstract
    Evidence supporting the impact of therapeutic zinc supplementation on the duration and severity of diarrhea among children under five is largely derived from studies conducted in South Asia. China experiences a substantial portion of the global burden of diarrhea, but the impact of zinc treatment among children under five has not been well documented by previously published systematic reviews on the topic. We therefore conducted a systematic literature review, which included an exhaustive search of the Chinese literature, in an effort to update previously published estimates of the effect of therapeutic zinc. We conducted systematic literature searches in various databases, including the China National Knowledge Infrastructure (CNKI), and abstracted relevant data from studies meeting our inclusion and exclusion criteria. We used STATA 12.0 to pool select outcomes and to generate estimates of percentage difference and relative risk comparing outcomes between zinc and control groups. We identified 89 Chinese and 15 non-Chinese studies for the review, including studies in 10 countries from all WHO geographic regions, and analyzed a total of 18,822 diarrhea cases (9469 zinc and 9353 control). None of the included Chinese studies had previously been included in published pooled effect estimates. Chinese and non-Chinese studies reported the effect of therapeutic zinc supplementation on decreased episode duration, stool output, stool frequency, hospitalization duration and proportion of episodes lasting beyond three and seven days. Pooling Chinese and non-Chinese studies yielded an overall 26% (95% CI: 20%-32%) reduction in the estimated relative risk of diarrhea lasting beyond three days among zinc-treated children. Studies conducted in and outside China report reductions in morbidity as a result of oral therapeutic zinc supplementation for acute diarrhea among children under five years of age. The WHO recommendation for zinc treatment of diarrhea episodes should be supported in all low- and middle-income countries.

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