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  • Original Article
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Zinc supplementation in the management of shigellosis in malnourished children in Bangladesh

European Journal of Clinical Nutrition volume 62, pages 849–855 (2008)Cite this article

Abstract

Objective:

To assess the impact of zinc supplementation on clinical recovery, weight gain and subsequent growth and morbidity in moderately malnourished children with shigellosis.

Design:

A randomized, double-blind, controlled trial.

Setting:

Dhaka hospital of ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh.

Subjects:

Fifty-six moderately malnourished children, aged 12–59 months with culture-proven shigellosis.

Methods:

Subjects were randomly allocated to receive zinc (20 mg/day elemental) in multivitamin syrup (intervention) or multivitamin syrup without zinc (control) in two equally divided doses daily for 2 weeks. All children received pivmecillinam in a dose of 15 mg/kg every 6 h for 5 days. After supplementation, children were followed in their respective homes every 2 weeks for 6 months.

Results:

Children receiving zinc recovered from acute illness significantly faster than the control children (P<0.05). The medians time (days) to recovery and disappearances of blood and mucous were significantly 50% shorter in the zinc-supplemented group compared to the control group. The mean body weight of zinc supplemented children increased significantly from 8.8 kg on admission to 9.2 kg (P<0.01) at recovery, which was not observed in the control children (from 9.3 to 9.6 kg; P=0.12). During the 6-month follow-up period, zinc-supplemented children had significantly fewer mean episodes of diarrhoea compared to the control children (2.2 vs 3.3; P=0.03).

Conclusion:

Zinc supplementation significantly shortens the duration of acute shigellosis, promotes better weight gain during recovery and reduces diarrhoeal morbidity during the subsequent 6 months.

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Acknowledgements

This research protocol/activity/study was funded by United States Agency for International Development (Grant no. HRN-A-00-96-90005-00) and Swedish Agency for Research Co-operation with Developing Countries (Sida/SAREC Agreement support; Grant 20002-2004). ICDDR,B acknowledges with gratitude the commitment of USAID and Sida/SAREC to the Centre's research efforts.

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Authors and Affiliations

  1. ICDDR B: Centre for Health and Population Research, Dhaka, Bangladesh

    S K Roy, R Raqib, W Khatun, T Azim, R Chowdhury & D A Sack

  2. Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    G J Fuchs

Authors
  1. S K Roy
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  2. R Raqib
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  3. W Khatun
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  4. T Azim
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  5. R Chowdhury
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  6. G J Fuchs
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  7. D A Sack
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Corresponding author

Correspondence to S K Roy.

Additional information

The Trial Registration:

The trial was registered on 08/05/2006 according to the clinical trial protocol registration system and the registration number is ‘NCT00321126’.

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Roy, S., Raqib, R., Khatun, W. et al. Zinc supplementation in the management of shigellosis in malnourished children in Bangladesh. Eur J Clin Nutr 62, 849–855 (2008). https://doi.org/10.1038/sj.ejcn.1602795

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602795

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