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You are a paediatric registrar who has just reviewed a child on the ward round admitted overnight with gastroenteritis. Your Senior house Officer (originally from a lower income country) asks whether you have considered giving zinc as this is commonly used in her hospital at home.
Structured clinical question
In children with acute gastroenteritis (AGE), does the use of adjunctive zinc enhance recovery time in high-income countries with a low risk of zinc deficiency?
Cochrane Library: 0 relevant.
Medline and Embase were searched using the following terms: Zinc, exp ZINC, gastr*)., exp GASTROENTERITIS, diarrh*, exp GASTROENTERITIS/OR exp ‘INFANTILE GASTROENTERITIS’/, exp DIARRHEA/OR exp ‘ACUTE DIARRHEA’/OR exp ‘INFANTILE DIARRHEA, DIARRHEA/OR "DIARRHEA, INFANTILE, child, exp CHILD, paediat, pediat*)., exp PEDIATRICS, Human age groups [Infant, newborn OR Infant OR Child, preschool OR Child OR Adolescent OR Young adult], Human age groups Infant to one year OR Child unspecified age OR Preschool Child 1 to 6 years OR School Child 7 to 12 years OR Adolescent 13 to 17 years. The search returned 26 articles. All available abstracts were reviewed to determine location of the study and applicability. Studies not concerning high-income countries were excluded at this point—consequently five randomised controlled trials (RCTs) were deemed relevant. An additional RCT based in Australia by Tran et al was found in a Cochrane review by Lazzerini and Wanzira.1 The final six published RCTs have been tabulated below (table 1).
In low-income and middle-income countries, diarrhoea is responsible for nearly 10% of child deaths under 5 years.2 This approximates to 500 000 deaths per year.3 While the burden of diarrhoeal disease is less in high-income countries, its prevalence still has a significant impact.4 Approximately 10% of European children under 5 years of age present to healthcare services with gastroenteritis annually, many of whom …
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