article · Journal of Pediatric Gastroenterology and Nutrition
Supplemental zinc helps shorten the duration of acute diarrhoea in young children, but it also carries a known risk of inducing vomiting. A secondary analysis evaluated data from 4,500 children aged 6 to 59 months across India and Tanzania who participated in a randomized trial testing different zinc doses. Overall, over a quarter of the children experienced vomiting. The findings indicate that clinical and demographic characteristics influence this side effect. Children who were dehydrated, underweight, or younger faced a higher risk of vomiting, as did those from households with wealth above the median. In addition, receipt of the rotavirus vaccine, which was almost entirely concordant with the trial site in Tanzania, was associated with higher vomiting risk. Conversely, older age and lower zinc doses were linked to reduced vomiting rates.
Zinc is a common and effective intervention for childhood diarrhoea, but treatment-induced vomiting can worsen fluid loss and hinder recovery. Understanding which clinical and demographic factors make children vulnerable helps healthcare providers identify at-risk patients, adjust management strategies, and prevent complications such as recurrent dehydration and poor nutrition.
The findings can inform paediatric treatment guidelines and the formulation of lower-dose zinc supplements designed to minimise side effects. The primary users are healthcare providers, public health bodies, and pharmaceutical manufacturers seeking to refine clinical protocols and product dosages. Because this is applied clinical trial evidence, the insights are directly relevant to informing current diarrhoea management practices and paediatric formulations.
AI-generated from the published abstract. Always read the original work before citing.
OBJECTIVES: Supplemental zinc during acute diarrhea reduces illness duration but also increases vomiting. In a recent trial, we found that children receiving lower daily doses of zinc (5 mg or 10 mg vs. 20 mg) had lower rates of vomiting with comparable stool output and duration of diarrhea. We performed a secondary analysis to identify sociodemographic and clinical factors associated with vomiting in children with acute diarrhea. METHODS: We performed a secondary data analysis of 4500 children aged 6-59 months with an acute episode of diarrhea (<72 h before enrollment) in a randomized, double-blind controlled trial in India and Tanzania. To identify clinically important risk factors for overall, regimen-related, and regimen-unrelated vomiting, we created log-binomial models with relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: The trial enrolled 4500 children, of whom 1203 (26.7%) had any vomiting. After adjusting for multiple demographic and clinical characteristics, the presence of dehydration (RR: 1.45, 95% CI: 1.10-1.92), being underweight (RR: 1.22, 95% CI: 1.05-1.41), receipt of the rotavirus vaccine (RR: 1.89, 95% CI: 1.69-2.12), and household wealth above the median (RR: 1.17, 95% CI: 1.07-1.29) were factors associated with an increased risk of vomiting. Rotavirus vaccine receipt was nearly 100% concordant with the study site of Tanzania. Older age and lower zinc dosing were associated with a lower risk of vomiting. CONCLUSIONS: Young, underweight, or dehydrated children are more likely to have concurrent vomiting with zinc supplementation. Identification of these factors may allow providers to better monitor such children, thus reducing the chances of recurrent dehydration or inadequate dietary intake.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.1002/jpn3.12441
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
