Micronutrients for the Prevention and Treatment of Diarrhea in Children in Low- and Middle-Income Countries

Abstract

Diarrhea is one of the leading causes of childhood morbidity and mortality. This review synthesizes the most recent evidence on micronutrients interventions for the prevention and treatment of diarrhea in children in low- and middle-income countries. Systematic reviews and high-quality trials were searched in the Cochrane Library, MEDLINE, and the e-Library of Evidence for Nutrition Actions (eLENA) in January 2014. Evidence supports a benefit of zinc supplementation for prevention and treatment of diarrhea, although this is limited to children over 6 months of age and in countries with moderate to high levels of zinc deficiency. Evidence supports the use of vitamin A supplementation for reducing all-cause mortality as well as diarrhea-related mortality, the substantial heterogeneity of findings in different studies remains unexplained. Multiple micronutrient powders have recently been associated with an increased risk of diarrhea and dysentery, which calls for careful monitoring in future studies as well as in ongoing programs.