IMPACT OF ZINC SUPPLEMENTATION ON MORBIDITY FROM DIARRHEA AND RESPIRATORY-INFECTIONS AMONG RURAL GUATEMALAN CHILDREN

Objective. A community-based, randomized, double-blind intervention tr ial was conducted to measure the impact of zinc supplementation on you ng Guatemalan children's morbidity from diarrhea and respiratory infec tions. Methods. Children aged 6 to 9 months were randomly assigned to receive 4 mL of a beverage containing 10 mg of zinc (as zinc sulfate) daily (7 d/wk) for 7 months (n = 45) or a placebo (n = 44). Morbidity data were collected daily. Diagnoses of diarrhea, fever, and anorexia were based on mothers' definitions. Respiratory infections were define d as the presence of: at least two of the following symptoms: runny no se, cough, wheezing, difficulty breathing, or fever. Results. High rat es of diarrhea and respiratory infections were reported, Children from the placebo group had a 20% episodic prevalence of diarrhea, with 8 e pisodes/100 d, and a 7% Episodic prevalence of respiratory infections, with 3 episodes/100 d. The median incidence of diarrhea among childre n who received zinc supplementation was reduced by 22% (Wilcoxon rank test), with larger reductions among boys and among children with weigh t-for-length at baseline lower than the median of the sample (39% redu ctions in both subgroups). Zinc supplementation also produced a 67% re duction in the percentage of children who had one or more episodes of persistent diarrhea (chi(2) test). No significant effects were found o n the episodic prevalence of diarrhea, the number of days per episode, or the episodic prevalence or incidence of respiratory infections. Co nclusions. The large impact of zinc supplementation on diarrhea incide nce suggests that young, rural Guatemalan children may be zinc deficie nt and that zinc supplementation may be an effective intervention to i mprove their health and growth.