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Meta-Analysis
. 2010 Apr;39 Suppl 1(Suppl 1):i63-9.
doi: 10.1093/ije/dyq023.

Zinc for the treatment of diarrhoea: effect on diarrhoea morbidity, mortality and incidence of future episodes

Christa L Fischer Walker  1 , Robert E Black
Affiliations
Meta-Analysis

Zinc for the treatment of diarrhoea: effect on diarrhoea morbidity, mortality and incidence of future episodes

Christa L Fischer Walker et al. Int J Epidemiol. 2010 Apr.

Abstract

Background: Zinc supplementation for the treatment of diarrhoea has been shown to decrease the duration and severity of the diarrhoeal episode, diarrhoea hospitalization rates and, in some studies, all-cause mortality. Using multiple outcome measures, we sought to estimate the effect of zinc for the treatment of diarrhoea on diarrhoea mortality and subsequent pneumonia mortality.

Methods: We conducted a systematic review of efficacy and effectiveness studies. We used a standardized abstraction and grading format and performed meta-analyses for all outcomes with >or=2 data points. The estimated effect on diarrhoea mortality was determined by applying the standard Child Health Epidemiology Reference Group rules for multiple outcomes.

Results: We identified 13 studies for abstraction. Zinc supplementation decreased the proportion of diarrhoeal episodes which lasted beyond 7 days, risk of hospitalization, all-cause mortality and diarrhoea mortality. Using diarrhoea hospitalizations as the closest and most conservative possible proxy for diarrhoea mortality, zinc for the treatment of diarrhoea is estimated to decrease diarrhoea mortality by 23%.

Conclusion: Zinc is an effective therapy for diarrhoea and will decrease diarrhoea morbidity and mortality when introduced and scaled-up in low-income countries.

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Figures

Figure 1
Figure 1
Synthesis of study identification in review of the effects of zinc for the treatment of diarrhoea on all-cause mortality, diarrhoea mortality, diarrhoea hospitalization and prolonged diarrhoea. (Final number of papers reported by outcome; thus one paper may be counted for more than one outcome).
Figure 2
Figure 2
Forest plot for the effect of zinc for the treatment of diarrhoea on diarrhoea hospitalizations.
Figure 3
Figure 3
Application of standardized rules for choice of final outcome to estimate effect of zinc on the reduction of diarrhoea mortality.
See this image and copyright information in PMC

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