Zinc therapy for different causes of diarrhea

  • Hafaz Zakky Abdillah Department of Child Health, University of North Sumatera Medical School, H. Adam Malik Hospital
  • Supriatmo Supriatmo Department of Child Health, University of North Sumatera Medical School, H. Adam Malik Hospital
  • Melda Deliana Department of Child Health, University of North Sumatera Medical School, H. Adam Malik Hospital
  • Selvi Nafianti Department of Child Health, University of North Sumatera Medical School, H. Adam Malik Hospital
  • Atan Baas Sinuhaji Department of Child Health, University of North Sumatera Medical School, H. Adam Malik Hospital
Keywords: acute non-bacterial diarrhea, zinc, acute bacterial diarrhea


Background The incidence of diarrhea in Indonesia has declined
in the past five years. In spite of the increasing number of studies
on the treatment for acute diarrhea, especially the use of zinc,
it is not known if bacterial vs. non-bacterial etiology makes a
difference in the reduction of severity of acute diarrhea in children
on zinc therapy.
Objective To assess the effect of zinc therapy in reducing the
severity of acute bacterial and non-bacterial diarrhea.
Methods We performed a cross-sectional study in the Secanggang
District, Lan gkat Regen cy of North Sumat era, from August
to November 2009 in children aged 2 months to 14 years .
Microscopic stool examination s were undertaken to separate
subjects into the acute bacterial or non-bacterial diarrhea groups.
Both groups received 10 mg/day ofzinc sulphate for subjects aged
<6 months or 20 mg/day for those aged 2:6 months for 10 days.
Measurement of disease severity was based on the frequency of
diarrhea (times/day) and the duration of diarrhea (hours) after
initial drug consumption . We performed indepen dent T test for
statistical an alysis.
Results Sixty-two children participated in this study, with 31
children in the acute bacterial group, and the remainder in the
non-bacterial group. There were no significant differences between
the two gro ups in frequency of diarrhea (2 .61 vs 2.70 times/day,
respectively, P=0.27) or in duration of diarrhea (63.39 vs 66.68
hours, respectively, P= 0.06) .
Conclusion Zinc is not more effective in reducing the severity
of acute bacterial diarrhea compared to non-bacterial diarrhea in


1. Afifah T, Djaja S, Irianto J. Kecenderungan penyakit penyebab
kematian bayi clan anak balita di indonesia: 1992-2001. Bui.
Penel. Kesehatan. 2003;31:48-59.
2. Sinuhaji AB, Sutanto AH. Mekanisme diare infeksius akut.
Cermin Dunia Kedokteran. 1992;80:44-6.
3. Noerasid H, Suratmadja S, Asnil PO. Gastroenteritis (diare)
akut. In: Suharyono, Boediarso A, Halimun EM, editors.
Gastroenterologi anak praktis. 4th ed. Jakarta: Balai Penerbit
FK-UI; 2003. p. 51-76.
4. Anggarwal R, Sentz J, Miller MA. Role of zinc administration
in prevention of childhood diarrhea and respiratory illness:
A meta-analysis. Pediatrics. 2007;119:1120-30.
5. 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.
6. Sur D, Gupta DN, Monda! SK, Ghosh S, Manna B, Rajendran
K, et al. Impact of zinc supplementation on diarrheal morbidity
and growth paterrn oflow birth weight infants in Kolkata,
India: A randomized, double-blind, placebo-controlled,
community-based study. Pediatrics. 2003; 112:1327-32.
7. WHO. The treatment of diarrhea, a manual for physicians
and other senior health workers, 4th revision. Geneva: WHO
Press; 2005. p. 23-4.
8. 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. J Am Coll Nutr. 2005;24:3 70-5.
9. Armin SA. Zat gizi mikro zink, dari aspek molekuler sampai
pada program kesehatan masyarakat. Suplement. 2005;26:29-
10. Wapnir RA. Zinc deficiency, malnutrition and the gastrointestinal
tract. J Nutr. 2000; 130: 1388-92.
11. Altaf W, Perveen S, Rehman KU, Teicberg S, Vancurova I,
Harper RG, et al. Zinc supplement ation in oral rehydration
solutions: experimental assessment and mech anisms of
action. J Am Coll Nutr. 2002;21:26-32.
12. Hoque KM, Rajendran VM, Binder HJ. Zinc inhibits cAMPstimulated
Cl secretion via basolateral K-channel blockade
in rat ileum. Am. J Physiol. Gastrointest. Liver Physiol.
13. Sazawal S, Black RE, Bhan MK, Bhandari N, Sinha A, J alla S.
Zinc supplementation in young children with acute diarrhea
in India. N Engl J Med. 1995;333:839-44.
14. Nguyen TV, Le Van P, Le Huy C, Weintraub A. Diarrhea
caused by rotavirus in children less than 5 years of age in Hanoi, Vietnam. J Clin Microbial. 2004;42:5745-50.
15. Khan SA, Ahmed A, Khalid SM. Diarrhea due to rotavirus
and probability of sewage contamination. J Islamic Acad Sci.
16. Hussein AM, Hassan MK. Rotavirus infection among
hospitalized children with acute watery diarrhea in BasrahIraq.
Bahrain Med Bull. 2000;22: 170-3.
17. Albert MJ, Faruque ASG, Faruque SM, Sack RB, Mahalanis
B. Case control study of enteropathogens associated with
childhood diarrhea in Dhaka, Bangladesh. J Clin Micro biol.
18. 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.
338 • Paediatr Irulones, Vol. 53, No. 6, November 2013
19. Almatsier S. Zink mineral. In: Almatsier S, editor. Prinsip
dasar ilmu gizi. Jakarta: Gramedia Pustaka Utama; 2003. p.
24 7-50.
20. Pudjiadi S. Kekurangan dan keracunan mineral. In: Pudjiadi
S, editor. Ilmu gizi klinis pada anak. 4th ed. Jakarta: Balai
Penerbit FK-UI; 2005. p. 205-6.
21. Subagyo B, Santoso N. Diare akut. In: Juffrie M, Soenarto
SS, Oswari H, AriefS, Rosalina I, Sri MN, editors. Buku ajar
gastroenterologi-hepatologi. Jakarta: Badan Penerbit IDAI;
2010. p. 87-120.
22. Larson CP, Hoque M, 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. J Health Popul N utr. 2005 ;23 :311-
23. Fontaine 0. Effect of zinc supplementation on clinical course
of acute diarrhoea. J Health Popul Nutt. 2001;19:339-46
How to Cite
Abdillah H, Supriatmo S, Deliana M, Nafianti S, Sinuhaji A. Zinc therapy for different causes of diarrhea. PI [Internet]. 30Dec.2013 [cited 19Jul.2024];53(6):334-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/373
Received 2016-08-29
Accepted 2016-08-29
Published 2013-12-30