Efficacy

Diarrhoea and pneumonia Short-term treatment of diarrhoea and possibly pneumonia with zinc supplementation has proven efficacious in numerous randomized controlled trials. A pooled analysis of nine randomized controlled trials reported an 18% lower incidence and a 25% reduction in prevalence of diarrhoea in zinc-supplemented children regardless of age, baseline zinc status, wasting prevalence, or sex, suggesting that zinc supplementation may benefit many subgroups of children living in areas at high risk of zinc deficiency. Studies have also investigated the efficacy of a combination of micronutrients given together with zinc and have shown that zinc alone is just as efficacious as a multiple micronutrient that includes zinc in reducing the severity of acute diarrhoea.

There is growing evidence that zinc supplementation reduces the risk of pneumonia. A pooled analysis of five randomized controlled trials reported a 34% reduction in the incidence of pneumonia in zinc-supplemented children, but evidence from three short-course zinc-supplementation trials suggests a non-significant reduction in the incidence of pneumonia and in hospi-talization rates for acute lower respiratory infection.

Other outcomes Evidence from a limited number of trials suggests a potential benefit of zinc supplementation on morbidity related to Plasmodium falciparum infections, child survival, weight gain in low-birth-weight infants and severely malnourished children, length gain in stunted children, and a host of maternal health and pregnancy outcomes; however, more research is required to determine the benefits of a large-scale zinc-supplementation program targeted at groups of infants, children, and pregnant women.

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