Oral zinc for treating diarrhoea in children

Marzia Lazzerini, Humphrey Wanzira, Marzia Lazzerini, Humphrey Wanzira

Abstract

Background: In developing countries, diarrhoea causes around 500,000 child deaths annually. Zinc supplementation during acute diarrhoea is currently recommended by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF).

Objectives: To evaluate oral zinc supplementation for treating children with acute or persistent diarrhoea.

Search methods: We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (the Cochrane Library 2016, Issue 5), MEDLINE, Embase, LILACS, CINAHL, mRCT, and reference lists up to 30 September 2016. We also contacted researchers.

Selection criteria: Randomized controlled trials (RCTs) that compared oral zinc supplementation with placebo in children aged one month to five years with acute or persistent diarrhoea, including dysentery.

Data collection and analysis: Both review authors assessed trial eligibility and risk of bias, extracted and analysed data, and drafted the review. The primary outcomes were diarrhoea duration and severity. We summarized dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD) with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses (using either a fixed-effect or random-effects model) and assessed heterogeneity.We assessed the certainty of the evidence using the GRADE approach.

Main results: Thirty-three trials that included 10,841 children met our inclusion criteria. Most included trials were conducted in Asian countries that were at high risk of zinc deficiency. Acute diarrhoeaThere is currently not enough evidence from well-conducted RCTs to be able to say whether zinc supplementation during acute diarrhoea reduces death or number of children hospitalized (very low certainty evidence).In children older than six months of age, zinc supplementation may shorten the average duration of diarrhoea by around half a day (MD -11.46 hours, 95% CI -19.72 to -3.19; 2581 children, 9 trials, low certainty evidence), and probably reduces the number of children whose diarrhoea persists until day seven (RR 0.73, 95% CI 0.61 to 0.88; 3865 children, 6 trials, moderate certainty evidence). In children with signs of malnutrition the effect appears greater, reducing the duration of diarrhoea by around a day (MD -26.39 hours, 95% CI -36.54 to -16.23; 419 children, 5 trials, high certainty evidence).Conversely, in children younger than six months of age, the available evidence suggests zinc supplementation may have no effect on the mean duration of diarrhoea (MD 5.23 hours, 95% CI -4.00 to 14.45; 1334 children, 2 trials, moderate certainty evidence), or the number of children who still have diarrhoea on day seven (RR 1.24, 95% CI 0.99 to 1.54; 1074 children, 1 trial, moderate certainty evidence).None of the included trials reported serious adverse events. However, zinc supplementation increased the risk of vomiting in both age groups (children greater than six months of age: RR 1.57, 95% CI 1.32 to 1.86; 2605 children, 6 trials, moderate certainty evidence; children less than six months of age: RR 1.54, 95% CI 1.05 to 2.24; 1334 children, 2 trials, moderate certainty evidence). Persistent diarrhoeaIn children with persistent diarrhoea, zinc supplementation probably shortens the average duration of diarrhoea by around 16 hours (MD -15.84 hours, 95% CI -25.43 to -6.24; 529 children, 5 trials, moderate certainty evidence).

Authors' conclusions: In areas where the prevalence of zinc deficiency or the prevalence of malnutrition is high, zinc may be of benefit in children aged six months or more. The current evidence does not support the use of zinc supplementation in children less six months of age, in well-nourished children, and in settings where children are at low risk of zinc deficiency.

Conflict of interest statement

Marzia Lazzerini has no known conflicts of interest. Humprey Wanzira has no known conflicts of interest.

Figures

1
1
Study flow diagram.
2
2
'Risk of bias' graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included trials.
3
3
'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included trial.
4
4
Zinc versus placebo for acute diarrhoea: diarrhoea duration (h)
5
5
Zinc versus placebo for acute diarrhoea: diarrhoea on day 7
6
6
Zinc versus placebo for acute diarrhoea: adverse events (vomiting)
7
7
Funnel plot of comparison: 1 Zinc versus placebo for children with acute diarrhoea, outcome: 1.1 Diarrhoea duration (hours).
8
8
Funnel plot of comparison: 1 Zinc versus placebo for children with acute diarrhoea, outcome: 1.12 Diarrhoea on day 7.
1.1. Analysis
1.1. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 1 Diarrhoea duration (hours).
1.2. Analysis
1.2. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 2 Diarrhoea duration (hours): subgrouped by nutritional status.
1.3. Analysis
1.3. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 3 Diarrhoea duration (hours): subgrouped by sex.
1.4. Analysis
1.4. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 4 Diarrhoea duration (hours); subgrouped by continent.
1.5. Analysis
1.5. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 5 Diarrhoea duration (hours): subgrouped by national risk of zinc deficiency.
1.6. Analysis
1.6. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 6 Diarrhoea duration (hours): subgrouped by zinc dose.
1.7. Analysis
1.7. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 7 Diarrhoea duration (hours): subgrouped by zinc type.
1.8. Analysis
1.8. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 8 Diarrhoea duration (hours): subgrouped by study setting.
1.9. Analysis
1.9. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 9 Diarrhoea duration (hours): subgrouped by concomitant treatment.
1.10. Analysis
1.10. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 10 Diarrhoea on day 3.
1.11. Analysis
1.11. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 11 Diarrhoea on day 5.
1.12. Analysis
1.12. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 12 Diarrhoea on day 7.
1.13. Analysis
1.13. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 13 Diarrhoea on day 7: subgrouped by nutritional status.
1.14. Analysis
1.14. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 14 Diarrhoea on day 7: subgrouped by sex.
1.15. Analysis
1.15. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 15 Diarrhoea on day 7: subgrouped by continent.
1.16. Analysis
1.16. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 16 Diarrhoea on day 7: subgrouped by national risk of zinc deficiency.
1.17. Analysis
1.17. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 17 Diarrhoea on day 7: subgrouped by zinc dose.
1.18. Analysis
1.18. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 18 Diarrhoea on day 7: subgrouped by zinc type.
1.19. Analysis
1.19. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 19 Diarrhoea on day 7: subgrouped by study setting.
1.20. Analysis
1.20. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 20 Diarrhoea on day 7: subgrouped by concomitant treatment.
1.21. Analysis
1.21. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 21 Stool frequency (stools /day).
1.22. Analysis
1.22. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 22 Death.
1.23. Analysis
1.23. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 23 Adverse events (vomiting).
1.24. Analysis
1.24. Analysis
Comparison 1 Zinc versus placebo for children with acute diarrhoea, Outcome 24 Difficulties in treatment administration.
2.1. Analysis
2.1. Analysis
Comparison 2 Zinc versus placebo for children with persistent diarrhoea, Outcome 1 Diarrhoea duration (hours).
2.2. Analysis
2.2. Analysis
Comparison 2 Zinc versus placebo for children with persistent diarrhoea, Outcome 2 Diarrhoea on day 3.
2.3. Analysis
2.3. Analysis
Comparison 2 Zinc versus placebo for children with persistent diarrhoea, Outcome 3 Diarrhoea on day 5.
2.4. Analysis
2.4. Analysis
Comparison 2 Zinc versus placebo for children with persistent diarrhoea, Outcome 4 Diarrhoea on day 7.
2.5. Analysis
2.5. Analysis
Comparison 2 Zinc versus placebo for children with persistent diarrhoea, Outcome 5 Stool frequency (stools/day).
2.6. Analysis
2.6. Analysis
Comparison 2 Zinc versus placebo for children with persistent diarrhoea, Outcome 6 Adverse events (vomiting).

References

References to studies included in this review Al‐Sonboli 2003 {published data only}

    1. Al‐Sonboli N, Gurgel RQ, Shenkin A, Hart CA, Cuevas LE. Zinc supplementation in Brazilian children with acute diarrhoea. Annals of Tropical Paediatrics 2003;23(1):3‐8.
    1. Cuevas LE, Al Sonboli NN, Gurgel RQ, Shenkins A, Hart CA. Impact of zinc on duration of acute diarrhoea in children. Journal of Infection 2000;40:A29.
Bahl 2002 {published data only}
    1. Bahl R, Bhandari N, Saksena M, Strand T, Kumar GT, Bhan MK, et al. Efficacy of zinc‐fortified oral rehydration solution in 6‐ to 35‐month‐old children with acute diarrhea. Journal of Pediatrics 2002;141(5):677‐82.
Bhatnagar 2004a {published data only}
    1. Bhatnagar S, Bahl R, Sharma PK, Kumar GT, Saxena SK, Bhan MK. Zinc with oral rehydration therapy reduces stool output and duration of diarrhea in hospitalized children: a randomized controlled trial. Journal of Pediatric Gastroenterology and Nutrition 2004;38(1):34‐40.
Bhutta 1999 {published data only}
    1. Bhutta ZA, Nizami SQ, Isani Z. Zinc supplementation in malnourished children with persistent diarrhea in Pakistan. Pediatrics 1999;103(4):e42.
Boran 2006 {published data only}
    1. Boran P, Tokuc G, Vagas E, Oktem S, Gokduman MK. Impact of zinc supplementation in children with acute diarrhoea in Turkey. Archives of Disease in Childhood 2006;91(4):296‐9.
Brooks 2005a {published data only}
    1. Brooks WA, Santosham M, Roy SK, Faruque AS, Wahed MA, Nahar K, et al. Efficacy of zinc in young infants with acute watery diarrhea. American Journal of Clinical Nutrition 2005;82(3):605‐10.
Brooks 2005a (20 mg) {published data only}
    1. Brooks WA, Santosham M, Roy SK, Faruque AS, Wahed MA, Nahar K, et al. Efficacy of zinc in young infants with acute watery diarrhea. American Journal of Clinical Nutrition 2005;82(3):605‐10.
Brooks 2005a (5 mg) {published data only}
    1. Brooks WA, Santosham M, Roy SK, Faruque AS, Wahed MA, Nahar K, et al. Efficacy of zinc in young infants with acute watery diarrhea. American Journal of Clinical Nutrition 2005;82(3):605‐10.
Crisinel 2015 {published data only}
    1. Crisinel PA, Verga ME, Kouame KS, Pittet A, Rey‐Bellet CG, Fountaine O, et al. Demonstration of the effectiveness of zinc in diarrhoea of children in Switzerland. European Journal of Pediatrics 2015;174(8):1061‐7.
Dalgic 2011 {published data only}
    1. Dalgic N, Sancar M, Bayraktar B, Pullu M, Hasim O. Probiotic, zinc and lactose‐free formula in children with rotavirus diarrhea: are they effective?. Pediatrics International 2011;53(5):677‐82.
Dutta 2000 {published data only}
    1. Dutta P, Mitra U, Datta A, Niyogi SK, Dutta S, Manna B, et al. Impact of zinc supplementation in malnourished children with acute watery diarrhoea. Journal of Tropical Pediatrics 2000;46(5):259‐63.
Dutta 2011 {published data only}
    1. Dutta P, Mitra U, Dutta S, Naik TN, Rajendran K, Chatterjee MK. Zinc, vitamin A, and micronutrient supplementation in children with diarrhea: a randomized controlled clinical trial of combination therapy versus monotherapy. Journal of Pediatrics 2011;159(4):633‐7.
Fajolu 2008 {published and unpublished data}
    1. Fajolu IB, Emokpae A, Oduwole AO, Silva BO, Abidoye RO, Renner JK. Zinc supplementation in children with acute diarrhoea. Nigerian Quarterly Journal of Hospital Medicine 2008;18(2):101‐3.
Faruque 1999 {published data only}
    1. Faruque AS, Mahalanabis D, Haque SS, Fuchs GJ, Habte D. Double‐blind, randomized, controlled trial of zinc or vitamin A supplementation in young children with acute diarrhoea. Acta Paediatrica 1999;88(2):154‐60.
Fischer Walker 2006 {published data only}
    1. Fischer Walker CL, Bhutta ZA, Bhandari N, Teka T, Shahid F, Taneja S, et al. Zinc supplementation for the treatment of diarrhea in infants in Pakistan, India and Ethiopia. Journal of Pediatric Gastroenterology and Nutrition 2006;43(3):357‐63.
Fischer Walker 2006 ETH {published data only}
    1. Fischer Walker CL, Bhutta ZA, Bhandari N, Teka T, Shahid F, Taneja S, et al. Zinc supplementation for the treatment of diarrhea in infants in Pakistan, India and Ethiopia. Journal of Pediatric Gastroenterology and Nutrition 2006;43(3):357‐63.
Fischer Walker 2006 IND {published data only}
    1. Fischer Walker CL, Bhutta ZA, Bhandari N, Teka T, Shahid F, Taneja S, et al. Zinc supplementation for the treatment of diarrhea in infants in Pakistan, India and Ethiopia. Journal of Pediatric Gastroenterology and Nutrition 2006;43(3):357‐63.
Fischer Walker 2006 PAK {published data only}
    1. Fischer Walker CL, Bhutta ZA, Bhandari N, Teka T, Shahid F, Taneja S, et al. Zinc supplementation for the treatment of diarrhea in infants in Pakistan, India and Ethiopia. Journal of Pediatric Gastroenterology and Nutrition 2006;43(3):357‐63.
Jiang 2016 {published data only}
    1. Jiang CX, Xu CD, Yang CQ. Therapeutic effects of zinc supplement as adjunctive therapy in infants and young children with rotavirus enteritis. Zhongguo Dang Dai Er Ke Za Zhi [Chinese Journal of Contemporary Pediatrics] 2016;18(9):826‐30.
Jin 2013 {published data only}
    1. Jin X‐L, Luo X‐M. Significance of zinc supplementation in infants with rotavirus enteritis. World Chinese Journal of Digestology 2013;21(35):4030‐3.
Karamyyar 2013 {published data only}
    1. Karamyyar M, Gheibi S, Noroozi M, Kord Valeshabad A. Therapeutic effects of oral zinc supplementation on acute diarrhoea with moderate dehydration: a double‐blind randomized clinical trial. Iranian Journal of Medical Sciences 2013;38(2):93‐9.
Khatun 2001 {published data only}
    1. Khatun UH, Malek MA, Black RE, Sarkar NR, Wahed MA, Fuchs G, et al. A randomized controlled clinical trial of zinc, vitamin A or both in undernourished children with persistent diarrhea in Bangladesh. Acta Paediatrica 2001;90(4):376‐80.
    1. Roy SK, Khatun F, Sarkar NR, Saifuddin NM, Islam OE, Fuchs GJ. A randomized four cell clinical trial of zinc and vitamin A in undernourished children with persistent diarrhoea in Bangladesh. Journal of Pediatric Gastroenterology and Nutrition 1998;26(5):595.
Larson 2005 {published data only}
    1. Larson CP, Hoque AB, Larson CP, Khan AM, Saha UR. Initiation of zinc treatment for acute childhood diarrhoea and risk for vomiting or regurgitation: a randomized, double‐blind, placebo‐controlled trial. Journal of Health, Population, and Nutrition 2005;23(4):311‐9.
Passariello 2015 {published data only}
    1. Passariello A, Nocerino R, Terrin G, Cecere G, Marco G, Micillo M, et al. Acceptability and efficacy of a gel hypotonic oral rehydration solution in children with acute gastroenteritis. European Journal of Gastroenterology and Hepatology 2015;27(5):523‐6.
Patel 2009 {published and unpublished data}
    1. Patel A, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Zinc and copper supplementation in acute diarrhea in children: a double‐blind randomized controlled trial. BMC Medicine 2009;7:22.
Patel 2009a (zinc) {published and unpublished data}
    1. Patel A, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Zinc and copper supplementation in acute diarrhea in children: a double‐blind randomized controlled trial. BMC Medicine 2009;7:22.
Patel 2009b (zinc + copper) {published and unpublished data}
    1. Patel A, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Zinc and copper supplementation in acute diarrhea in children: a double‐blind randomized controlled trial. BMC Medicine 2009;7:22.
Patel 2015 {published data only}
    1. Patel HN, Shah RB, Gajjar BM. Evaluation of the role of zinc supplementation in treatment of diarrhoea in paediatric patients: a randomized open‐label study. Drugs & Therapy Perspectives 2015;31(1):34‐8.
Patro 2010 {published and unpublished data}
    1. Patro B, Szymański H, Szajewska H. Oral zinc for the treatment of acute gastroenteritis in Polish children: a randomized, double‐blind, placebo‐controlled trial. Journal of Pediatrics 2010;157(6):984‐8.e.1.
Penny 1999 {published data only}
    1. Penny ME, Peerson JM, Marin RM, Duran A, Lanata CF, Lönnerdal B, et al. Randomized, community‐based trial of the effect of zinc supplementation, with and without other micronutrients, on the duration of persistent childhood diarrhea in Lima, Peru. Journal of Pediatrics 1999;135(2 Pt 1):208‐17.
Polat 2003 {published data only}
    1. Polat TB, Uysalol M, Cetinkaya F. Efficacy of zinc supplementation on the severity and duration of diarrhea in malnourished Turkish children. Pediatrics International 2003;45(5):555‐9.
Polat 2003 (low Zn) {published data only}
    1. Polat TB, Uysalol M, Cetinkaya F. Efficacy of zinc supplementation on the severity and duration of diarrhea in malnourished Turkish children. Pediatrics International 2003;45(5):555‐9.
Polat 2003 (normal Zn) {published data only}
    1. Polat TB, Uysalol M, Cetinkaya F. Efficacy of zinc supplementation on the severity and duration of diarrhea in malnourished Turkish children. Pediatrics International 2003;45(5):555‐9.
Roy 1997 {published data only}
    1. Roy SK. Effect of zinc supplementation in patients with acute and persistent diarrhoea. Glimpse 1991;13(3):2.
    1. Roy SK, Tomkins AM, Akramuzzaman SM, Behrens RH, Haider R, Mahalanabis D, et al. Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea. Archives of Disease in Childhood 1997;77(3):196‐200.
Roy 1998 {published data only}
    1. Roy SK. Effect of zinc supplementation in patients with acute and persistent diarrhoea. Glimpse 1991;13(3):2.
    1. Roy SK, Tomkins AM, Mahalanabis D, Akramuzzaman SM, Haider R, Behrens RH, et al. Impact of zinc supplementation on persistent diarrhoea in malnourished Bangladeshi children. Acta Paediatrica 1998;87(12):1235‐9.
Roy 2008a {published and unpublished data}
    1. Roy SK, Raqib R, Khatun W, Azim T, Chowdhury R, Fuchs GJ, et al. Zinc supplementation in the management of shigellosis in malnourished children in Bangladesh. European Journal of Clinical Nutrition 2008;62(7):849‐55.
Sachdev 1988 {published data only}
    1. Sachdev HP, Mittal NK, Mittal SK, Yadav HS. A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants. Journal of Pediatric Gastroenterology and Nutrition 1988;7(6):877‐81.
Sachdev 1990 {published data only}
    1. Sachdev HP, Mittal NK, Yadav HS. Oral zinc supplementation in persistent diarrhoea in infants. Annals of Tropical Paediatrics 1990;10(1):63‐9.
Sazawal 1995 {published data only}
    1. Darmon N, Briend A, Desjeux JF. Zinc in the treatment of diarrhea. Journal of Pediatric Gastroenterology and Nutrition 1997;25(3):363‐5.
    1. Folwaczny C. Role of zinc in treatment of acute diarrhea. Zeitschrift für Gastroenterologie 1996;34(4):260‐2.
    1. Sazawal S, Black RE, Bhan MK, Bhandari N, Sinha A, Jalla S. Zinc supplementation in young children with acute diarrhea in India. New England Journal of Medicine 1995;333(13):839‐44.
Shimelis 2008 {published data only}
    1. Shimelis D, Benti D, Challi D. Effect of zinc supplementation in treatment of acute diarrhoea among 2‐59 months children treated in Black Lion Hospital, Addis Ababa, Ethiopia. Ethiopian Journal of Health Development 2008;22(2):187‐90.
Strand 2002 {published data only}
    1. Strand TA, Chandyo RK, Bahl R, Sharma PR, Adhikari RK, Bhandari N, et al. Effectiveness and efficacy of zinc for the treatment of acute diarrhea in young children. Pediatrics 2002;109(5):898‐903.
Tran 2015 {published data only}
    1. Tran CD, Hawkes J, Graham RD, Kitchen JL, Symonds EL, Davidson GP, et al. Zinc‐fortified oral rehydration solution improved intestinal permeability and small intestinal mucosal recovery. Clinical Pediatrics 2015;54(7):676‐82.
References to studies excluded from this review Abraham 2016 {published data only}
    1. Abraham AA, Amritha SR, Selvin CDS. A comparative evaluation on the effect of zinc‐probiotic and probiotic therapy in paediatric acute diarrhoea and the impact of counselling of mothers. International Journal of Pharmacy and Pharmaceutical Sciences 2016;8(7):241‐3.
Adu‐Afarwuah 2007 {published data only}
    1. Adu‐Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: effects on growth and motor development. American Journal of Clinical Nutrition 2007;86(2):412‐20.
Adu‐Afarwuah 2008 {published data only}
    1. Adu‐Afarwuah S, Lartey A, Brown KH, Zlotkin S, Briend A, Dewey KG. Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana. American Journal of Clinical Nutrition 2008;87(4):929‐38.
Aggarwal 2007 {published data only}
    1. Aggarwal R, Sentz J, Miller MA. Role of zinc administration in prevention of childhood diarrhea and respiratory illnesses: a meta‐analysis. Pediatrics 2007;119(6):1120‐30.
Agustina 2007 {published data only}
    1. Agustina R, Lukito W, Firmansyah A, Suhardjo HN, Murniati D, Bindels J. The effect of early nutritional supplementation with a mixture of probiotic, prebiotic, fiber and micronutrients in infants with acute diarrhea in Indonesia. Asia Pacific Journal of Clinical Nutrition 2007;16(3):435‐42.
Alam 2010 {published data only}
    1. Alam DS, Yunus M, Arifeen S, Chowdury HR, Larson CP, Sack DA, et al. Zinc treatment for 5 or 10 days is equally efficacious in preventing diarrhea in the subsequent 3 months among Bangladeshi children. Journal of Nutrition 2010;141(2):312‐5.
Alarcon 2004 {published data only}
    1. Alarcon K, Kolsteren PW, Prada AM, Chian AM, Velarde RE, Pecho IL, et al. Effects of separate delivery of zinc or zinc and vitamin A on hemoglobin response, growth, and diarrhea in young Peruvian children receiving iron therapy for anemia. American Journal of Clinical Nutrition 2004;80(5):1276‐82.
Awasthi 2006 {published data only}
    1. Awasthi S, INCLEN Childnet Zinc Effectiveness for Diarrhea (IC‐ZED) Group. Zinc supplementation in acute diarrhea is acceptable, does not interfere with oral rehydration, and reduces the use of other medications: a randomized trial in five countries. Journal of Pediatric Gastroenterology and Nutrition 2006;42(3):300‐5.
Baqui 2002 {published data only}
    1. Baqui AH, Black RE, 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.
    1. Baqui AH, Black RE, Arifeen S, Yunus M, Zaman K, Begum N, et al. Zinc therapy for diarrhoea increased the use of oral rehydration therapy and reduced the use of antibiotics in Bangladeshi children. Journal of Health, Population, and Nutrition 2004;22(4):440‐2.
Baqui 2003 {published data only}
    1. Baqui AH, Zaman K, Persson LA, Arifeen S, Yunus M, Begum N, et al. Simultaneous weekly supplementation of iron and zinc is associated with lower morbidity due to diarrhea and acute lower respiratory infection in Bangladeshi infants. Journal of Nutrition 2003;133(12):4150‐7.
Baqui 2006 {published data only}
    1. Baqui AH, Black RE, Fischer Walker CL, Arifeen S, Zaman K, Yunus M, et al. Zinc supplementation and serum zinc during diarrhea. Indian Journal of Pediatrics 2006;73(6):493‐7.
Baum 2010 {published data only}
    1. Baum MK, Lai S, Sales S, Page JB, Campa A. Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV‐infected adults. Clinical Infectious Diseases 2010;50(12):1653‐60.
Becquey 2016 {published data only}
    1. Becquey E, Ouedraogo CT, Hess SY, Rouamba N, Prince L, Ouedraogo JB, et al. Comparison of Preventive and Therapeutic Zinc Supplementation in Young Children in Burkina Faso: A Cluster‐Randomized, Community‐Based Trial. Journal of Nutrition 2016;146(10):2058‐66.
Behrens 1990 {published data only}
    1. Behrens RH, Tomkins AM, Roy SK. Zinc supplementation during diarrhoea, a fortification against malnutrition?. Lancet 1990;336(8712):442‐3.
Bhandari 2002 {published data only}
    1. Bhandari N, Bahl R, Taneja S, Strand T, Mølbak K, Ulvik RJ, et al. Substantial reduction in severe diarrheal morbidity by daily zinc supplementation in young north Indian children. Pediatrics 2002;109(6):e86.
Bhandari 2005 {published data only}
    1. Bhandari N, Mazumder S, Taneja S, Dube B, Black RE, Fontaine O, et al. A pilot test of the addition of zinc to the current case management package of diarrhea in a primary health care setting. Journal of Pediatric Gastroenterology and Nutrition 2005;41(5):685‐7.
Bhandari 2007 {published data only}
    1. Bhandari N, Taneja S, Mazumder S, Bahl R, Fontaine O, Bhan MK. Adding zinc to supplemental iron and folic acid does not affect mortality and severe morbidity in young children. Journal of Nutrition 2007;137(1):112‐7.
Bhandari 2008 {published data only}
    1. Bhandari N, Mazumder S, Taneja S, Dube B, Agarwal RC, Mahalanabis D, et al. Effectiveness of zinc supplementation plus oral rehydration salts compared with oral rehydration salts alone as a treatment for acute diarrhea in a primary care setting: a cluster randomized trial. Pediatrics 2008;121(5):e1279‐85.
Bhatnagar 2004b {published data only}
    1. Bhatnagar S, Natchu UC. Zinc in child health and disease. Indian Journal of Pediatrics 2004;71(11):991‐5.
Bhutta 2000a {published data only}
    1. Bhutta ZA, Raza F, Nizami SQ, Issani Z. Does zinc supplementation influence appetite in malnourished children with persistent diarrhoea? A randomized controlled trial in Pakistan. Journal of Pediatric Gastroenterology and Nutrition 2000;31(Suppl 2):23.
Bilenko 2010 {published data only}
    1. Bilenko N, Belmaker I, Vardi H, Fraser D. Efficacy of multiple micronutrient supplementations on child health: study design and baseline characteristics. Israel Medical Association Journal 2010;12(6):342‐7.
Black 2001 {published data only}
    1. Black RE, Sazawal S. Zinc and childhood infectious disease morbidity and mortality. British Journal of Nutrition 2001;85(Suppl 2):S125‐9.
Bobat 2005 {published data only}
    1. Bobat R, Coovadia H, Stephen C, Naidoo KL, McKerrow N, Black RE, et al. Safety and efficacy of zinc supplementation for children with HIV‐1 infection in South Africa: a randomised double‐blind placebo‐controlled trial. Lancet 2005;366(9500):1862‐7.
Borges 2007 {published data only}
    1. Borges Dantas CV, Veiga Black AP, dos Santos Barroso G, Oliveira de Jesus EF, Barbosa Serpa RF, Moreira S, et al. Association among serum concentration of minerals, anthropometric indices and diarrhea in low‐income children in the metropolitan region of Rio de Janeiro, Brazil [Associação entre concentrações séricas de minerais, índices antropométricos e ocorrência de diarréia entre crianças de baixa renda da região metropolitana do Rio de Janeiro]. Revista de Nutricao 2007;20(2):159‐69.
Brooks 2005b {published data only}
    1. Brooks WA, Santosham M, Naheed A, Goswami D, Wahed MA, Diener‐West M, et al. Effect of weekly zinc supplements on incidence of pneumonia and diarrhoea in children younger than 2 years in an urban, low‐income population in Bangladesh: randomised controlled trial. Lancet 2005;366(9490):999‐1004.
Brown 2007 {published data only}
    1. Brown KH, López de Romaña D, Arsenault JE, Peerson JM, Penny ME. Comparison of the effects of zinc delivered in a fortified food or a liquid supplement on the growth morbidity and plasma zinc concentrations of young Peruvian children. American Journal of Clinical Nutrition 2007;85(2):538‐47.
Bruzzese 2016 {published data only}
    1. Bruzzese E, Fedele MC, Bruzzese D, Viscovo S, Giannattasio A, Mandato C, et al. Randomised clinical trial: a Lactobacillus GG and micronutrient‐containing mixture is effective in reducing nosocomial infections in children, vs. placebo. Alimentary Pharmacology & Therapeutics 2016;44(6):568‐75.
Cárcamo 2006 {published data only}
    1. Cárcamo C, Hooton T, Weiss NS, Gilman R, Wener MH, Chavez V, et al. Randomized controlled trial of zinc supplementation for persistent diarrhea in adults with HIV‐1 infection. Journal of Acquired Immune Deficiency Syndromes 2006;43(2):197‐201.
Chandyo 2010 {published data only}
    1. Chandyo RK, Shrestha PS, Valentiner‐Branth P, Mathisen M, Basnet S, Ulak M, et al. Two weeks of zinc administration to Nepalese children with pneumonia does not reduce the incidence of pneumonia or diarrhea during the next six months. Journal of Nutrition 2010;140(9):1677‐82.
Chang 2010 {published data only}
    1. Chang S, Arifeen S, Bari S, Wahed MA, Rahman KM, Rahman MT, et al. Supplementing iron and zinc: double blind, randomized evaluation of separate or combined delivery. European Journal of Clinical Nutrition 2010;64(2):153‐60.
Chen 2010 {published data only}
    1. Chen K, Zhang X, Li TY, Chen L, Wei XP, Qu P, et al. Effect of vitamin A, vitamin A plus iron and multiple micronutrient‐fortified seasoning powder on infectious morbidity of preschool children. Nutrition 2010;27(4):428‐34.
Chhagan 2009 {published data only}
    1. Chhagan MK, Broeck J, Luabeya KK, Mpontshane N, Tucker KL, Bennish ML. Effect of micronutrient supplementation on diarrhoeal disease among stunted children in rural South Africa. European Journal of Clinical Nutrition 2009;63(7):850‐7.
Chhagan 2010 {published data only}
    1. Chhagan MK, Broeck J, Luabeya KK, Mpontshane N, Tomkins A, Bennish ML. Effect on longitudinal growth and anemia of zinc or multiple micronutrients added to vitamin A: a randomized controlled trial in children aged 6‐24 months. BMC Public Health 2010;10:145.
Christian 2009 {published data only}
    1. Christian P, Stewart CP, LeClerq SC, Wu L, Katz J, West KP Jr, et al. Antenatal and postnatal iron supplementation and childhood mortality in rural Nepal: a prospective follow‐up in a randomized, controlled community trial. American Journal of Epidemiology 2009;170(9):1127‐36.
CIGNIS 2010 {published data only}
    1. Chilenje Infant Growth, Nutrition and Infection (CIGNIS) Study Team. Micronutrient fortification to improve growth and health of maternally HIV‐unexposed and exposed Zambian infants: a randomised controlled trial. PLOS ONE 2010;5(6):e11165.
Colgate 2016 {published data only}
    1. Colgate ER, Haque R, Dickson DM, Carmolli MP, Mychaleckyj JC, Nayak U, et al. Delayed dosing of oral rotavirus vaccine demonstrates decreased risk of rotavirus gastroenteritis associated with serum zinc: a randomized controlled trial. Clinical Infectious Diseases 2016;63(5):634‐41.
Coronel Carbajal 2000 {published data only}
    1. Coronel Carbajal C. Micronutrients: an option in the treatment of acute diarrheal diseases [Micronutrientes: una opción en el tratamiento de las enfermedades diarreicas agudas]. Revista Cubana de Pediatría 2000;72(4):261‐6.
Cross 2009 {published data only}
    1. Cross AJ, Heath AL, Ferguson EL, Gray AR, Szymlek‐Gay EA. Rates of common communicable illnesses in non‐anaemic 12‐24 month old South Island, New Zealand children. New Zealand Medical Journal 2009;122(1290):24‐35.
Dhingra 2009 {published data only}
    1. 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. Journal of Health, Population, and Nutrition 2009;27(5):632‐9.
Doherty 1998 {published data only}
    1. Doherty CP, Sarkar MA, Shakur MS, Ling SC, Elton RA, Cutting WA. Zinc and rehabilitation from severe protein‐energy malnutrition: higher‐dose regimens are associated with increased mortality. American Journal of Clinical Nutrition 1998;68(3):742‐8.
Ebrahimi 2006 {published data only}
    1. Ebrahimi S, Pormahmodi A, Kamkar A. Study of zinc supplementation on growth of schoolchildren in Yasuj, Southwest of Iran. Pakistan Journal of Nutrition 2006;5(4):341‐2.
Ellis 2007 {published data only}
    1. Ellis AA, Winch P, Daou Z, Gilroy KE, Swedberg E. Home management of childhood diarrhoea in southern Mali‐‐implications for the introduction of zinc treatment. Social Science and Medicine 2007;64(3):701‐12.
Ferraz 2007 {published data only}
    1. Ferraz IS, Daneluzzi JC, Vannucchi H, Jordão Jr AA, Ricco RG, Ciampo LA, et al. Zinc serum levels and their association with vitamin A deficiency in preschool children [Nível sérico de zinco e sua associação com deficiência de vitamina A em crianças pré‐escolares]. Jornal de Pediatria 2007;83(6):512‐7.
Ferrufino 2007 {unpublished data only}
    1. Ferrufino B, Sagrario A. Aceptabilidad de las madres de la suplementación del sulfato de zinc en el manejo de las enfermedades diarreicas en menores de 5 años, municipio de Jinotega. Noviembre del año 2006 a marzo del año 2007 [Acceptability of mothers of zinc sulphate supplementation in children under 5 years in the municipality of Jinotega. November 2006 to March 2007]. [Masters thesis]. Managua: Universidad Nacional Autónoma de Nicaragua, 2007.
Fischer Walker 2008 {published data only}
    1. Fischer Walker CL, Black RE, Baqui AH. Does age affect the response to zinc therapy for diarrhoea in Bangladeshi infants?. Journal of Health, Population, and Nutrition 2008;26(1):105‐9.
Gardner 2005 {published data only}
    1. Gardner JM, Powell CA, Baker‐Henningham H, Walker SP, Cole TJ, Grantham‐McGregor SM. Zinc supplementation and psychosocial stimulation: effects on the development of undernourished Jamaican children. American Journal of Clinical Nutrition 2005;82(2):399‐405.
Garenne 2007 {published data only}
    1. Garenne M, Becher H, Ye Y, Kouyate B, Muller O. Sex‐specific responses to zinc supplementation in Nouna, Burkina Faso. Journal of Pediatric Gastroenterology and Nutrition 2007;44(5):619‐28.
Gebremedhin 2016 {published data only}
    1. Gebremedhin S, Mamo G, Gezahign H, Kung'u J, Adish A. The effectiveness bundling of zinc with Oral Rehydration Salts (ORS) for improving adherence to acute watery diarrhea treatment in Ethiopia: cluster randomised controlled trial. BMC Public Health 2016;16:457.
Gregorio 2007 {published data only}
    1. Gregorio GV, Dans LF, Cordero CP, Panelo CA. Zinc supplementation reduced cost and duration of acute diarrhea in children. Journal of Clinical Epidemiology 2007;60(6):560‐6.
Gupta 2003 {published data only}
    1. Gupta DN, Mondal SK, Ghosh S, Rajendran K, Sur D, Manna B. Impact of zinc supplementation on diarrhoeal morbidity in rural children of West Bengal, India. Acta Paediatrica 2003;92(5):531‐6.
Gupta 2007 {published data only}
    1. Gupta DN, Rajendran K, Mondal SK, Ghosh S, Bhattacharya SK. Operational feasibility of implementing community‐based zinc supplementation: impact on childhood diarrheal morbidity. Pediatric Infectious Disease Journal 2007;26(4):306‐10.
Habib 2010 {published data only}
    1. Habib MA, Soofi SB, Bhutta ZA. Effect of zinc in tablet and suspension formulations in the treatment of acute diarrhoea among young children in an emergency setting of earthquake affected region of Pakistan. Journal of the College of Physicians and Surgeons Pakistan 2010;20(12):837‐8.
Habib 2013 {published data only}
    1. Habib MA, Soofi S, Sadiq K, Samejo T, Hussain M, Mirani M, et al. A study to evaluate the acceptability, feasibility and impact of packaged interventions ("Diarrhea Pack") for prevention and treatment of childhood diarrhea in rural Pakistan. BMC Public Health 2013;13:922.
Heinig 2006 {published data only}
    1. Heinig MJ, Brown KH, Lönnerdal B, Dewey KG. Zinc supplementation does not affect growth, morbidity, or motor development of US term breastfed infants at 4‐10 mo of age. American Journal of Clinical Nutrition 2006;84(3):594‐601.
Hess 2015 {published data only}
    1. Hess SY, Abbeddou S, Jimenez EY, Somé JW, Vosti SA, Ouédraogo ZP, et al. Small‐quantity lipid‐based nutrient supplements, regardless of their zinc content, increase growth and reduce the prevalence of stunting and wasting in young Burkinabe children: a cluster‐randomized trial. PLOS ONE 2015;10(3):e0122242.
Hettiarachchi 2008 {published data only}
    1. Hettiarachchi M, Liyanage C, Wickremasinghe R, Hilmers DC, Abrams SA. The efficacy of micronutrient supplementation in reducing the prevalence of anaemia and deficiencies of zinc and iron among adolescents in Sri Lanka. European Journal of Clinical Nutrition 2008;62(7):856‐65.
Hidayat 1998 {published data only}
    1. Hidayat A, Achadi A, Sunoto, Soedarmo SP. The effect of zinc supplementation in children under three years of age with acute diarrhea in Indonesia. Medical Journal of Indonesia 1998;7(4):237–41.
Hoque 2006 {published data only}
    1. Hoque KM, Binder HJ. Zinc in the treatment of acute diarrhea: current status and assessment. Gastroenterology 2006;130(7):2201‐5.
Hyder 2007 {published data only}
    1. Hyder SM, Haseen F, Khan M, Schaetzel T, Jalal CS, Rahman M, et al. A multiple‐micronutrient‐fortified beverage affects hemoglobin, iron, and vitamin A status and growth in adolescent girls in rural Bangladesh. Journal of Nutrition 2007;137(9):2147‐53.
Iannotti 2010 {published data only}
    1. Iannotti LL, Zavaleta N, León Z, Huasquiche C, Shankar AH, Caulfield LE. Maternal zinc supplementation reduces diarrheal morbidity in Peruvian infants. Journal of Pediatrics 2010;156(6):960‐4, 964.e1‐2.
Islam 2010 {published data only}
    1. Islam MN, Chowdhury MA, Siddika M, Qurishi SB, Bhuiyan MK, Hoque MM, et al. Effect of oral zinc supplementation on the growth of preterm infants. Indian Pediatrics 2010;47(10):845‐9.
Jimenez 2000 {published data only}
    1. Jimenez R, Sagaro E, Lafita Y. How growth infants supplemented with zinc sulfate after an episode of persistent diarrhea. Journal of Pediatric Gastroenterology and Nutrition 2000;31 Suppl 2:S26.
Kelly 1999 {published data only}
    1. Kelly P, Musonda R, Kafwembe E, Kaetano L, Keane E, Farthing M. Micronutrient supplementation in the AIDS diarrhoea‐wasting syndrome in Zambia: a randomized controlled trial. AIDS 1999;13(4):495‐500.
Kelly 2010 {published data only}
    1. Kelly P, Shawa T, Mwanamakondo S, Soko R, Smith G, Barclay GR, et al. Gastric and intestinal barrier impairment in tropical enteropathy and HIV: limited impact of micronutrient supplementation during a randomised controlled trial. BMC Gastroenterology 2010;10:72.
Kianmehr 2016 {published data only}
    1. Kianmehr M, Saber A, Moshari J, Ahmadi R, Basiri‐Moghadam M. The effect of G‐ORS along with rice soup in the treatment of acute diarrhea in children: a single‐blind randomized controlled trial. Nursing and Midwifery Studies 2016;5(2):e25852.
Larson 2010 {published data only}
    1. Larson CP, Nasrin D, Saha A, Chowdhury MI, Qadri F. The added benefit of zinc supplementation after zinc treatment of acute childhood diarrhoea: a randomized, double‐blind field trial. Tropical Medicine & International Health 2010;15(6):754‐61.
Lin 2008 {published data only}
    1. Lin CA, Manary MJ, Maleta K, Briend A, Ashorn P. An energy‐dense complementary food is associated with a modest increase in weight gain when compared with a fortified porridge in Malawian children aged 6‐18 months. Journal of Nutrition 2008;138(3):593‐8.
Lind 2004 {published data only}
    1. Lind T, Lönnerdal B, Stenlund H, Gamayanti IL, Ismail D, Seswandhana R, et al. A community‐based randomized controlled trial of iron and zinc supplementation in Indonesian infants: effects on growth and development. American Journal of Clinical Nutrition 2004;80(3):729‐36.
Lind 2008 {published data only}
    1. Lind T, Seswandhana R, Persson LA, Lönnerdal B. Iron supplementation of iron‐replete Indonesian infants is associated with reduced weight‐for‐age. Acta Paediatrica 2008;97(6):770‐5.
Lira 1998 {published data only}
    1. Lira PI, Ashworth A, Morris SS. Effect of zinc supplementation on the morbidity, immune function, and growth of low‐birth‐weight, full‐term infants in northeast Brazil. American Journal of Clinical Nutrition 1998;68(2 Suppl):418S‐24S.
Long 2006 {published data only}
    1. Long KZ, Montoya Y, Hertzmark E, Santos JI, Rosado JL. A double‐blind, randomized, clinical trial of the effect of vitamin A and zinc supplementation on diarrheal disease and respiratory tract infections in children in Mexico City, Mexico. American Journal of Clinical Nutrition 2006;83(3):693‐700.
Long 2007 {published data only}
    1. Long KZ, Rosado JL, Montoya Y, Lourdes Solano M, Hertzmark E, DuPont HL, et al. Effect of vitamin A and zinc supplementation on gastrointestinal parasitic infections among Mexican children. Pediatrics 2007;120(4):e846‐55.
Lopez 2005 {published data only}
    1. López de Romaña G, Cusirramos S, López de Romaña D, Gross R. Efficacy of multiple micronutrient supplementation for improving anemia, micronutrient status, growth, and morbidity of Peruvian infants. Journal of Nutrition 2005;135(3):646S‐52S.
Luabeya 2007 {published data only}
    1. Luabeya KK, Mpontshane N, Mackay M, Ward H, Elson I, Chhagan M, et al. Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial. PLOS ONE 2007;2(6):e541.
Makonnen 2003a {published data only}
    1. Makonnen B, Venter A, Joubert G. A randomized controlled study of the impact of dietary zinc supplementation in the management of children with protein‐energy malnutrition in Lesotho. I: Mortality and morbidity. Journal of Tropical Pediatrics 2003;49(6):340‐52.
Makonnen 2003b {published data only}
    1. Makonnen B, Venter A, Joubert G. A randomized controlled study of the impact of dietary zinc supplementation in the management of children with protein‐energy malnutrition in Lesotho. II: Special investigations. Journal of Tropical Pediatrics 2003;49(6):353‐60.
Manger 2008 {published data only}
    1. Manger MS, McKenzie JE, Winichagoon P, Gray A, Chavasit V, Pongcharoen T, et al. A micronutrient‐fortified seasoning powder reduces morbidity and improves short‐term cognitive function, but has no effect on anthropometric measures in primary school children in northeast Thailand: a randomized controlled trial. American Journal of Clinical Nutrition 2008;87(6):1715‐22.
Maragkoudaki 2016 {published data only}
    1. Maragkoudaki M, Chouliaras G, Moutafi A, Thomas A, Orfanakou A, Papadopoulou A. Efficacy of an ORS enriched with L. reuteri DSM 17938 and zinc in infants with acute gastroenteritis: A double blind, placebo controlled trial. Journal of Pediatric Gastroenterology and Nutrition Conference: 49th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, ESPGHAN. 2016.
Martinez‐Estevez 2016 {published data only}
    1. Martinez‐Estevez NS, Alvarez‐Guevara AN, Rodriguez‐Martinez CE. Effects of zinc supplementation in the prevention of respiratory tract infections and diarrheal disease in Colombian children: A 12‐month randomised controlled trial. Allergologia et Immunopathologia 2016;44(4):368‐75.
Mazariegos 2010 {published data only}
    1. Mazariegos M, Hambidge KM, Westcott JE, Solomons NW, Raboy V, Das A, et al. Neither a zinc supplement nor phytate‐reduced maize nor their combination enhance growth of 6‐ to 12‐month‐old Guatemalan infants. Journal of Nutrition 2010;140(5):1041‐8.
Mazumder 2010 {published data only}
    1. Mazumder S, Taneja S, Bhandari N, Dube B, Agarwal RC, Mahalanabis D, et al. Effectiveness of zinc supplementation plus oral rehydration salts for diarrhoea in infants aged less than 6 months in Haryana state, India. Bulletin of the World Health Organization 2010;88(10):754‐60.
Mda 2010 {published data only}
    1. Mda S, Raaij JM, Villiers FP, MacIntyre UE, Kok FJ. Short‐term micronutrient supplementation reduces the duration of pneumonia and diarrheal episodes in HIV‐infected children. Journal of Nutrition 2010;140(5):969‐74.
Meeks Gardner 1998 {published data only}
    1. Meeks Gardner J, Witter MM, Ramdath DD. Zinc supplementation: effects on the growth and morbidity of undernourished Jamaican children. European Journal of Clinical Nutrition 1998;52(1):34‐9.
Müller 2001 {published data only}
    1. Müller O, Becher H, Zweeden AB, Ye Y, Diallo DA, Konate AT, et al. Effect of zinc supplementation on malaria and other causes of morbidity in west African children: randomised double blind placebo controlled trial. BMJ 2001;322(7302):1567.
Naheed 2009 {published data only}
    1. Naheed A, Walker Fischer CL, Mondal D, Ahmed S, Arifeen SE, Yunus M, et al. Zinc therapy for diarrhoea improves growth among Bangladeshi infants 6 to 11 months of age. Journal of Pediatric Gastroenterology and Nutrition 2009;48(1):89‐93.
Nasrin 2005 {published data only}
    1. Nasrin D, Larson CP, Sultana S, Khan TU. Acceptability of and adherence to dispersible zinc tablet in the treatment of acute childhood diarrhoea. Journal of Health, Population, and Nutrition 2005;23(3):215‐21.
Negi 2014 {published data only}
    1. Negi R, Dewan P, Shah D, Das S, Bhatnagar S, Gupta P. Oral zinc supplements are ineffective for treating acute dehydrating diarrhoea in 5‐12‐year‐olds. Acta Paediarica 2014;104(8):e367‐71.
Nga 2009 {published data only}
    1. Nga TT, Winichagoon P, Dijkhuizen MA, Khan NC, Wasantwisut E, Furr H, et al. Multi‐micronutrient‐fortified biscuits decreased prevalence of anemia and improved micronutrient status and effectiveness of deworming in rural Vietnamese school children. Journal of Nutrition 2009;139(5):1013‐21.
Osendarp 2002 {published data only}
    1. Osendarp SJ, Santosham M, Black RE, Wahed MA, Raaij JM, Fuchs GJ. Effect of zinc supplementation between 1 and 6 mo of life on growth and morbidity of Bangladeshi infants in urban slums. American Journal of Clinical Nutrition 2002;76(6):1401‐8.
Ouedraogo 2008 {published data only}
    1. Ouedraogo HZ, Dramaix‐Wilmet M, Zeba AN, Hennart P, Donnen P. Effect of iron or multiple micronutrient supplements on the prevalence of anaemia among anaemic young children of a malaria‐endemic area: a randomized double‐blind trial. Tropical Medicine and International Health 2008;13(10):1257‐66.
Passariello 2010 {published data only}
    1. Passariello A, Terrin G, Marco G, Cecere G, Ruotolo S, Marino A, et al. Efficacy of a new hypotonic oral rehydration solution containing zinc and prebiotics in the treatment of childhood acute diarrhea: a randomized controlled trial. Journal of Pediatrics 2011;158(2):288‐92.e1.
Patel 2005 {published data only}
    1. Patel AB, Dhande LA, Rawat MS. Therapeutic evaluation of zinc and copper supplementation in acute diarrhea in children: double blind randomized trial. Indian Pediatrics 2005;42(5):433‐42.
Patel 2010a {published data only}
    1. Patel AB, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Influence of zinc supplementation in acute diarrhea differs by the isolated organism. International Journal of Pediatrics 2010;2010:671587.
Patel 2010b {published data only}
    1. Patel A, Mamtani M, Dibley MJ, Badhoniya N, Kulkarni H. Therapeutic value of zinc supplementation in acute and persistent diarrhea: a systematic review. PLOS ONE 2010;5(4):e10386.
Patel 2012 {published data only}
    1. Patel AB, Dibley MJ, Mamtani M, Badhoniya N, Kulkarni H. Therapeutic zinc and copper supplementation in acute diarrhea does not influence short‐term morbidity and growth: double‐blind randomized controlled trial. Pediatric Infectious Disease Journal 2013;32(1):91‐3.
Penny 2004a {published data only}
    1. Penny ME, Marin RM, Duran A, Peerson JM, Lanata CF, Lönnerdal B, et al. Randomized controlled trial of the effect of daily supplementation with zinc or multiple micronutrients on the morbidity, growth, and micronutrient status of young Peruvian children. American Journal of Clinical Nutrition 2004;79(3):457‐65.
Penny 2004b {published data only}
    1. Penny ME, Black RE, Brown KH, Lönnerdal B. Reply to RJ Walden [Letter to the Editor]. American Journal of Clinical Nutrition 2004;80(4):1084‐5.
Polat 2006 {published data only}
    1. Polat B, Tokuc G, Vagas E, Oktem S, Gokduman MK. Impact of zinc supplementation in children with acute diarrhoea in Turkey. Archives of Disease in Childhood 2006;91(4):296‐9.
Prado 2016 {published data only}
    1. Prado EL, Abbeddou S, Jimenez EY, Some JW, Ouedraogo ZP, Vosti SA, et al. Lipid‐based nutrient supplements plus malaria and diarrhea treatment increase infant development scores in a cluster‐randomized trial in Burkina Faso. Journal of Nutrition 146;4:814‐22.
Rahman 2001 {published data only}
    1. Rahman MM, Vermund SH, Wahed MA, Fuchs GJ, Baqui AH, Alvarez JO. Simultaneous zinc and vitamin A supplementation in Bangladeshi children: randomised double blind controlled trial. BMJ 2001;323(7308):314‐8.
Rahman 2005 {published data only}
    1. Rahman MJ, Sarker P, Roy SK, Ahmad SM, Chisti J, Azim T, et al. Effects of zinc supplementation as adjunct therapy on the systemic immune responses in shigellosis. American Journal of Clinical Nutrition 2005;81(2):495‐502.
Raqib 2004 {published data only}
    1. Raqib R, Roy SK, Rahman MJ, Azim T, Ameer SS, Chisti J, et al. Effect of zinc supplementation on immune and inflammatory responses in pediatric patients with shigellosis. American Journal of Clinical Nutrition 2004;79(3):444‐50.
Richard 2006 {published data only}
    1. Richard SA, Zavaleta N, Caulfield LE, Black RE, Witzig RS, Shankar AH. Zinc and iron supplementation and malaria, diarrhea, and respiratory infections in children in the Peruvian Amazon. American Journal of Tropical Medicine and Hygiene 2006;75(1):126‐32.
Rollins 2007 {published data only}
    1. Rollins NC, Broeck J, Kindra G, Pent M, Kasambira T, Bennish ML. The effect of nutritional support on weight gain of HIV‐infected children with prolonged diarrhoea. Acta Paediatrica 2007;96(1):62‐8.
Rosado 1997 {published data only}
    1. Rosado JL, López P, Muñoz E, Martinez H, Allen LH. Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers. American Journal of Clinical Nutrition 1997;65(1):13‐9.
Rosado 1998 {published data only}
    1. Rosado JL. Zinc deficiency and its functional implications [Deficiencia de zinc y sus implicaciones funcionales]. Salud Pública de México 1998;40(2):181‐8.
Rosado 2009 {published data only}
    1. Rosado JL, Caamaño MC, Montoya YA, Lourdes Solano M, Santos JI, Long KZ. Interaction of zinc or vitamin A supplementation and specific parasite infections on Mexican infants' growth: a randomized clinical trial. European Journal of Clinical Nutrition 2009;63(10):1176‐84.
Roy 1992 {published data only}
    1. Roy SK, Akramuzzaman SM, Haider R, Mahalanabis D, Behrens RH, Wahed MA, et al. Zinc supplementation in diarrhoea: nutritional implication on clinical recovery and intestinal permeability [Abstract]. Journal of Gastroenterology and Hepatology 1994;9(6):A166.
    1. Roy SK, Behrens RH, Haider R, Akramuzzaman SM, Mahalanabis D, Wahed MA, et al. Impact of zinc supplementation on intestinal permeability in Bangladeshi children with acute diarrhoea and persistent diarrhoea syndrome. Journal of Pediatric Gastroenterology and Nutrition 1992;15(3):289‐96.
Roy 1999 {published data only}
    1. Roy SK, Tomkins AM, Haider R, Behren RH, Akramuzzaman SM, Mahalanabis D, et al. Impact of zinc supplementation on subsequent growth and morbidity in Bangladeshi children with acute diarrhoea. European Journal of Clinical Nutrition 1999;53(7):529‐34.
Roy 2007 {published data only}
    1. Roy SK, Tomkins AM, Akramuzzaman SM, Chakraborty B, Ara G, Biswas R, et al. Impact of zinc supplementation on subsequent morbidity and growth in Bangladeshi children with persistent diarrhoea. Journal of Health, Population, and Nutrition 2007;25(1):67‐74.
Roy 2008b {published data only}
    1. Roy SK, Hossain MJ, Khatun W, Chakraborty B, Chowdhury S, Begum A, et al. Zinc supplementation in children with cholera in Bangladesh: randomised controlled trial. BMJ 2008;336(7638):266‐8.
Ruel 1997 {published data only}
    1. Ruel MT, Rivera JA, Santizo MC, Lönnerdal B, Brown KH. Impact of zinc supplementation on morbidity from diarrhea and respiratory infections among rural Guatemalan children. Pediatrics 1997;99(6):808‐13.
Sabatier 1997 {published data only}
    1. Sabatier García FJ, Izquierdo Estévez A, León García RE, Díaz Fernández L. Benefits of zinc in the treatment of infants presenting with diarrhea [Beneficios del cinc en el tratamiento de niños con diarrea]. Revista Cubana de Pediatría 1997;69(3/4):197‐200.
Sáenz De Pipaón 2007 {published data only}
    1. Sáenz De Pipaón M, Sancho Martinez A, Quero Jiménez J. Effects of supplementation with zinc in the first year of life [Efectos de la suplementación con cinc en el primer año de vida]. Revista Española De Pediatría 2007;63(6):464‐82.
Samuel 1995 {published data only}
    1. Samuel MJ. Paediatrics Forum. Acute diarrhoea. Africa Health 1995;17(5):27, 29‐30.
Sazawal 1996 {published data only}
    1. Sazawal S, Black RE, Bhan MK, Jalla S, Bhandari N, Sinha A, et al. Zinc supplementation reduces the incidence of persistent diarrhea and dysentery among low socio‐economic children in India. Journal of Nutrition 1996;126(2):443‐50.
Sazawal 1997a {published data only}
    1. Sazawal S, Black RE, Bhan MK, Jalla S, Sinha A, Bhandari N. Efficacy of zinc supplementation in reducing the incidence and prevalence of acute diarrhea ‐ a community‐based, double‐blind, controlled trial. American Journal of Clinical Nutrition 1997;66(2):413‐8.
Sazawal 2004 {published data only}
    1. Sazawal S, Marwah D, Sazawal S, Black RE, Deb S, Dhingra U, et al. Efficacy of zinc and iron fortification of milk in prevention of anemia, diarrhea pneumonia, and iron deficiency‐ a community based double masked randomized trial. Journal of Pediatric Gastroenterology and Nutrition 2004;39 Suppl 1:417‐8.
Sazawal 2007a {published data only}
    1. Sazawal S, Dhingra U, Dhingra P, Hiremath G, Kumar J, Sarkar A, et al. Effects of fortified milk on morbidity in young children in north India: community based randomised double masked placebo controlled trial. BMJ 2007;334(7585):140.
Sazawal 2007b {published data only}
    1. Sazawal S, Dhingra U, Deb S, Bhan MK, Menon VP, Black RE. Effect of zinc added to multi‐vitamin supplementation containing low‐dose vitamin A on plasma retinol level in children‐‐a double‐blind randomized, controlled trial. Journal of Health, Population, and Nutrition 2007;25(1):62‐6.
Sazawal 2007c {published data only}
    1. Sazawal S, Black RE, Ramsan M, Chwaya HM, Dutta A, Dhingra U, et al. Effect of zinc supplementation on mortality in children aged 1‐48 months: a community‐based randomised placebo‐controlled trial. Lancet 2007;369(9565):927‐34.
Shamir 2005 {published data only}
    1. Shamir R, Makhoul IR, Etzioni A, Shehadeh N. Evaluation of a diet containing probiotics and zinc for the treatment of mild diarrheal illness in children younger than one year of age. Journal of the American College of Nutrition 2005;24(5):370‐5.
Shankar 1998 {published data only}
    1. Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection. American Journal of Clinical Nutrition 1998;68(2 Suppl):447S‐63S.
Sharieff 2006 {published data only}
    1. Sharieff W, Bhutta Z, Schauer C, Tomlinson G, Zlotkin S. Micronutrients (including zinc) reduce diarrhoea in children: the Pakistan Sprinkles Diarrhoea Study. Archives of Disease in Childhood 2006;91(7):573‐9.
Sheikh 2010 {published data only}
    1. Sheikh A, Shamsuzzaman S, Ahmad SM, Nasrin D, Nahar S, Alam MM, et al. Zinc influences innate immune responses in children with enterotoxigenic Escherichia coli‐induced diarrhea. Journal of Nutrition 2010;140(5):1049‐56.
Sur 2003 {published data only}
    1. Sur D, Gupta DN, Mondal SK, Ghosh S, Manna B, Rajendran K, et al. Impact of zinc supplementation on diarrheal morbidity and growth pattern of low birth weight infants in Kolkata, India: a randomized, double‐blind, placebo‐controlled, community‐based study. Pediatrics 2003;112(6 Pt 1):1327‐32.
Taneja 2009 {published data only}
    1. Taneja S, Bhandari N, Rongsen‐Chandola T, Mahalanabis D, Fontaine O, Bhan MK. Effect of zinc supplementation on morbidity and growth in hospital‐born, low‐birth‐weight infants. American Journal of Clinical Nutrition 2009;90(2):385‐91.
Taneja 2010 {published data only}
    1. Taneja S, Strand TA, Sommerfelt H, Bahl R, Bhandari N. Zinc supplementation for four months does not affect growth in young north Indian children. Journal of Nutrition 2010;140(3):630‐4.
Tielsch 2006 {published data only}
    1. Tielsch JM, Khatry SK, Stoltzfus RJ, Katz J, LeClerq SC, Adhikari R, et al. Effect of routine prophylactic supplementation with iron and folic acid on preschool child mortality in southern Nepal: community‐based, cluster‐randomised, placebo‐controlled trial. Lancet 2006;367(9505):144‐52.
Tielsch 2007 {published data only}
    1. Tielsch JM, Khatry SK, Stoltzfus RJ, Katz J, LeClerq SC, Adhikari R, et al. Effect of daily zinc supplementation on child mortality in southern Nepal: a community‐based, cluster randomised, placebo‐controlled trial. Lancet 2007;370(9594):1230‐9.
Umeta 2000 {published data only}
    1. Umeta M, West CE, Haidar J, Deurenberg P, Hautvast JG. Zinc supplementation and stunted infants in Ethiopia: a randomised controlled trial. Lancet 2000;355(9220):2021‐6.
Untoro 2005 {published data only}
    1. Untoro J, Karyadi E, Wibowo L, Erhardt MW, Gross R. Multiple micronutrient supplements improve micronutrient status and anemia but not growth and morbidity of Indonesian infants: a randomized, double‐blind, placebo‐controlled trial. Journal of Nutrition 2005;135(3):639S‐45S.
Valery 2005 {published data only}
    1. Valery PC, Torzillo PJ, Boyce NC, White AV, Stewart PA, Wheaton GR, et al. Zinc and vitamin A supplementation in Australian Indigenous children with acute diarrhoea: a randomised controlled trial. Medical Journal of Australia 2005;182(10):530‐5.
Veenemans 2011 {published data only}
    1. Veenemans J, Mank T, Ottenhof M, Baidjoe A, Mbugi EV, Demir AY, et al. Protection against diarrhea associated with Giardia intestinalis Is lost with multi‐nutrient supplementation: a study in Tanzanian children. PLoS Neglected Tropical Diseases 2011;5(6):e1158.
Wadhwa 2011 {published data only}
    1. Wadhwa N, Natchu UC, Sommerfelt H, Strand TA, Kapoor V, Saini S, et al. ORS containing zinc does not reduce duration or stool volume of acute diarrhea in hospitalized children. Journal of Pediatric Gastroenterology and Nutrition 2011;53(2):161‐7.
Walden 2004 {published data only}
    1. Walden RJ. Supplementation with zinc and other minerals. American Journal of Clinical Nutrition 2004;80(4):1084.
Walker 2007 {published data only}
    1. Walker CL, Bhutta ZA, Bhandari N, Teka T, Shahid F, Taneja S, et al. Zinc during and in convalescence from diarrhea has no demonstrable effect on subsequent morbidity and anthropometric status among infants <6 mo of age. American Journal of Clinical Nutrition 2007;85(3):887‐94.
Wieringa 2010 {published data only}
    1. Wieringa FT, Dijkhuizen MA, Muhilal, Meer JW. Maternal micronutrient supplementation with zinc and beta‐carotene affects morbidity and immune function of infants during the first 6 months of life. European Journal of Clinical Nutrition 2010;64(10):1072‐9.
Winch 2006 {published data only}
    1. Winch PJ, Gilroy KE, Doumbia S, Patterson AE, Daou Z, Coulibaly S, et al. Prescription and administration of a 14‐day regimen of zinc treatment for childhood diarrhea in Mali. American Journal of Tropical Medicine and Hygiene 2006;74(5):880‐3.
Winch 2008 {published data only}
    1. Winch PJ, Gilroy KE, Doumbia S, Patterson AE, Daou Z, Diawara A, et al. Operational issues and trends associated with the pilot introduction of zinc for childhood diarrhoea in Bougouni district, Mali. Journal of Health, Population, and Nutrition 2008;26(2):151‐62.
Wuehler 2008 {published data only}
    1. Wuehler SE, Sempértegui F, Brown KH. Dose‐response trial of prophylactic zinc supplements, with or without copper, in young Ecuadorian children at risk of zinc deficiency. American Journal of Clinical Nutrition 2008;87(3):723‐33.
References to ongoing studies NCT01140074 {unpublished data only}
    1. NCT01140074. Efficacy of zinc sulfate with probiotics for the treatment of acute diarrhea in children (zinc) [Effectiveness and efficacy of zinc with probiotics for the treatment of acute diarrhea in young children]. (first received 7 June 2010).
NCT01198587 {unpublished data only}
    1. NCT01198587. Oral zinc for the treatment of acute diarrhea in US children [A double blind randomized placebo controlled trial of oral zinc for children with acute diarrhea in a developed nation]. (first received 2 September 2010).
Additional references Albert 2003
    1. Albert MJ, Qadri F, Wahed MA, Ahmed T, Rahman AS, Ahmed F, et al. Supplementation with zinc, but not vitamin A, improves seroconversion to vibriocidal antibody in children given an oral cholera vaccine. Journal of Infectious Diseases 2003;187(6):909‐13.
Berni Canani 2010
    1. Berni Canani R, Buccigrossi V, Passariello A. Mechanisms of action of zinc in acute diarrhea. Current Opinion in Gastroenterology 2011;27(1):8‐12.
Beshgetoor 1998
    1. Beshgetoor D, Hambidge M. Clinical conditions altering copper metabolism in humans. American Journal of Clinical Nutrition 1998;67(5 Suppl):1017S‐21S.
Bhutta 2000b
    1. Bhutta ZA, Bird SM, Black RE, Brown KH, Gardner JM, Hidayat A, 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):1516‐22.
Brown 2003
    1. Brown KH. Diarrhea and malnutrition. Journal of Nutrition 2003;133(1):328S‐32S.
Das 2014
    1. Das JK, Salam RA, Bhutta ZA. Global burden of childhood diarrhea and interventions. Current Opinion in Infectious Diseases 2014;27(5):451‐8.
Dijkhuizen 2001
    1. Dijkhuizen MA, Wieringa FT, West CE, Martuti S, Muhilal. Effects of iron and zinc supplementation in Indonesian infants on micronutrient status and growth. Journal of Nutrition 2001;131(11):2860‐5.
Fischer Walker 2005
    1. Fischer Walker C, Kordas K, Stoltzfus RJ, Black RE. Interactive effects of iron and zinc on biochemical and functional outcomes in supplementation trials. American Journal Clinical Nutrition 2005;82(1):5‐12.
Fontaine 2001
    1. Fontaine O. Effect of zinc supplementation on clinical course of acute diarrhoea. Journal of Health, Population, and Nutrition 2001;19(4):339‐46.
Garenne 2005
    1. Garenne M, Becher H, Ye Y, Kouyate B, Müller O. Sex‐specific responses to zinc supplementation in Nouna, Burkina Faso. Journal of Pediatric Gastroenterology and Nutrition 2007;44(5):619‐28.
GRADEpro GDT 2014 [Computer program]
    1. GRADE Working Group, McMaster University. GRADEpro GDT. Version accessed 1 September 2016. Hamilton (ON): GRADE Working Group, McMaster University, 2014.
Gunshin 1997
    1. Gunshin H, Mackenzie B, Berger UV, Gunshin Y, Romero MF, Boron WF, et al. Cloning and characterization of a mammalian proton‐coupled metal‐ion transporter. Nature 1997;388(6641):482‐8.
Haider 2009
    1. Haider BA, Bhutta ZA. The effect of therapeutic zinc supplementation among young children with selected infections:a review of the evidence. Food and Nutrition Bulletin 2009;30(1 Suppl):S41‐59.
Hess 2009
    1. Hess SY, Lönnerdal B, Hotz C, Rivera JA, Brown KH. Recent advances in knowledge of zinc nutrition and human health. Food and Nutrition Bulletin 2009;30(1 Suppl):S5‐11.
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from . The Cochrane Collaboration.
Hoque 2005
    1. Hoque KM, Rajendran VM, Binder HJ. Zinc inhibits cAMP‐stimulated Cl secretion via basolateral K‐channel blockade in rat ileum. American Journal of Physiology, Gastrointestinal and Liver Physiology 2005;288(5):G956‐63.
Hoque 2009
    1. Hoque KM, Sarker R, Guggino SE, Tse CM. A new insight into pathophysiological mechanisms of zinc in diarrhea. Annals of the New York Academy of Sciences 2009;1165:279–84.
Iqbal 2001
    1. Iqbal AS, Shahidullah M, Islam MN, Akhter S, Banu S. Serum zinc and copper levels in the maternal blood and cord blood of neonates. Indian Journal of Pediatrics 2001;68(6):523‐6.
IZiNCG 2004
    1. International Zinc Nutrition Consultative Group (IZiNCG), Hotz C, Brown KH, editor(s). Assessment of the risk of zinc deficiency in population and options for its control. Food and Nutrition Bulletin 2004;25(1 Suppl 2):S91‐202.
Kordas 2004
    1. Kordas K, Stoltzfus RJ. New evidence of iron and zinc interplay at the enterocyte and neural tissues. Journal of Nutrition 2004;134(6):1295‐8.
Krebs 1999
    1. Krebs NF. Zinc transfer to the breastfed infant. Journal of Mammary Gland Biology and Neoplasia 1999;4(3):259‐68.
Krebs 2014
    1. Krebs NF, Miller LV, Hambidge KM. Zinc deficiency in infants and children: a review of its complex and synergistic interactions. Paediatrics and International Child Health 2014;34(4):279–88.
Lazzerini 2016
    1. Lazzerini M. Oral zinc provision in acute diarrhea. Current Opinion in Clinical Nutrition and Metabolic Care 2016;19(3):239‐43.
Liberato 2015
    1. Liberato SC, Singh G, Mulholland K. Zinc supplementation in young children: a review of the literature focusing on diarrhoea prevention and treatment. Clinical Nutrition 2015;34(2):181‐8.
Liu 2015a
    1. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000‐13, with projections to inform post‐2015 priorities: an updated systematic analysis. Lancet 2015;385(9966):430‐40.
Liu 2015b
    1. Liu L, Black RE, Cousens S, Mathers C, Lawn JE, Hogan DR. Causes of child death: comparison of MCEE and GBD 2013 estimates. Lancet 2015;385(9986):2461‐2.
Lukacik 2008
    1. Lukacik M, Thomas RL, Aranda JV. A meta‐analysis of the effects of oral zinc in the treatment of acute and persistent diarrhea. Pediatrics 2008;121(2):326‐36.
MacDonald 2000
    1. MacDonald RS. The role of zinc in growth and cell proliferation. Journal of Nutrition 2000;130(5S Suppl):1500S‐8S.
O'Dell 2000
    1. O'Dell BL. Role of zinc in plasma membrane function. Journal of Nutrition 2000;130(5S Suppl):1432S‐6S.
Patro 2008
    1. Patro B, Golicki D, Szajewska H. Meta‐analysis: zinc supplementation for acute gastroenteritis in children. Alimentary Pharmacology & Therapeutics 2008;28(6):713‐23.
Powell 2000
    1. Powell SR. The antioxidant properties of zinc. Journal of Nutrition 2000;130(5S Suppl):1447S‐54S.
Prasad 2008
    1. Prasad AS. Zinc in human health: effect of zinc on immune cells. Molecular Medicine 2008;14(5‐6):353‐7.
Prasad 2014
    1. Prasad AS. Zinc is an antioxidant and anti‐inflammatory agent: its role inhuman health. Frontiers in Nutrition 2014;1:14. [DOI: 10.3389/fnut.2014.00014]
Review Manager 5 [Computer program]
    1. Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager 5 (RevMan 5). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Sazawal 1997b
    1. Sazawal S, Jalla S, Mazumder S, Sinha A, Black RE, Bhan MK. Effect of zinc supplementation on cell‐mediated immunity and lymphocyte subsets in preschool children. Indian Pediatrics 1997;34(7):589‐97.
Wagstaff 2004
    1. Wagstaff A, Bustreo F, Bryce J, Claeson M, WHO‐World Bank Child Health and Poverty Working Group. Child health: reaching the poor. American Journal of Public Health 2004;94(5):726‐36.
Wessells 2012
    1. Wessells KR, Brown KH. Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting. PLOS ONE 2012;7(11):e50568. [DOI: 10.1371/journal.pone.0050568]
WHO/UNICEF 2004
    1. World Health Organization Department of Child and Adolescent Health and Development/UNICEF. Clinical management of acute diarrhoea: WHO/UNICEF joint statement [WHO/FCH/CAH/04.7; UNICEF/PD/Diarrhoea/01]. Geneva: World Health Organization, 2004.
Wieringa 2015
    1. Wieringa FT, Dijkhuizen MA, Fiorentino M, Laillou A, Berger J. Determination of zinc status in humans: which indicator should we use?. Nutrients 2015;7(5):3252–63.
Zlotkin 1988
    1. Zlotkin SH, Cherian MG. Hepatic metallothionein as a source of zinc and cysteine during the first year of life. Pediatric Research 1988;24(3):326‐9.
Zlotkin 2003
    1. Zlotkin S, Arthur P, Schauer C, Antwi KY, Yeung G, Piekarz A. Home‐fortification with iron and zinc sprinkles or iron sprinkles alone successfully treats anemia in infants and young children. Journal of Nutrition 2003;133(4):1075‐80.
Zou 2015
    1. Zou TT, Mou J, Zhan X. Zinc supplementation in acute diarrhea. Indian Journal of Pediatrics 2015;82(5):415‐20. [DOI: 10.1007/s12098-014-1504-6]
References to other published versions of this review Lazzerini 2005
    1. Lazzerini M, Ronfani L. Oral zinc for treating diarrhoea in children. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD005436]
Lazzerini 2008
    1. Lazzerini M, Ronfani L. Oral zinc for treating diarrhoea in children. Cochrane Database of Systematic Reviews 2008, Issue 3. [DOI: 10.1002/14651858.CD005436.pub2]
Lazzerini 2012
    1. Lazzerini M, Ronfani L. Oral zinc for treating diarrhoea in children. Cochrane Database of Systematic Reviews 2012, Issue 6. [DOI: 10.1002/14651858.CD005436.pub3]
Lazzerini 2013
    1. Lazzerini M, Ronfani L. Oral zinc for treating diarrhoea in children. Cochrane Database of Systematic Reviews 2013, Issue 1. [DOI: 10.1002/14651858.CD005436.pub4]

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