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Zinc supplementation in children with cholera in Bangladesh: randomised controlled trial

BMJ 2008; 336 doi: (Published 31 January 2008) Cite this as: BMJ 2008;336:266
  1. S K Roy, senior scientist,
  2. M Jahangir Hossain, assistant scientist,
  3. Wajiha Khatun, research officer,
  4. Barnali Chakraborty, research officer,
  5. S Chowdhury, research physician,
  6. Afroza Begum, research assistant,
  7. Syeda Mah-e-Muneer, research assistant,
  8. Sohana Shafique, research investigator,
  9. Mansura Khanam, research assistant,
  10. R Chowdhury, research physician
  1. 1International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka –1212, Bangladesh
  1. Correspondence to: S K Roy skroy{at}
  • Accepted 11 November 2007


Objective To investigate the impact of zinc supplementation in children with cholera.

Design Double blind, randomised, placebo controlled trial.

Setting Dhaka Hospital, Bangladesh.

Participants 179 children aged 3-14 years with watery diarrhoea and stool dark field examination positive for Vibrio cholerae and confirmed by stool culture.

Intervention Children were randomised to receive 30 mg elemental zinc per day (n=90) or placebo (n=89) until recovery. All children received erythromycin suspension orally in a dose of 12.5 mg/kg every six hours for three days.

Main outcome measures Duration of diarrhoea and stool output.

Results 82 children in each group completed the study. More patients in the zinc group than in the control group recovered by two days (49% v 32%, P=0.032) and by three days (81% v 68%, P=0.03). Zinc supplemented patients had 12% shorter duration of diarrhoea than control patients (64.1 v 72.8 h, P=0.028) and 11% less stool output (1.6 v 1.8 kg/day, P=0.039).

Conclusion Zinc supplementation significantly reduced the duration of diarrhoea and stool output in children with cholera. Children with cholera should be supplemented with zinc to reduce its duration and severity.

Trial registration Clinical trials NCT00226616.


  • Contributors: SKR contributed to the design of the study, secured funding, supervised patient management and clinical evaluation, and provided substantial advice on data analysis and critical interpretation of results. MJH contributed to the design of the study, and supervised patient management, clinical evaluation, and writing the manuscript. WK contributed to analysis and interpretation of data and writing the manuscript. BC, SC, AB, SMM, SS, MK, and RC were involved with interpreting the results and writing the manuscript. SKR is the guarantor.

  • Funding: World Bank grant for nutrition centre of excellence at ICDDR,B and Thrasher Research Fund, USA. The funding sources had no role in study design, data collection, analysis, interpretation of data, or in writing this report.

  • Competing interests: None declared.

  • Ethical approval: Ethical review committee of ICDDR, B.

  • Provenance and peer review: Not commissioned; externally peer reviewed.

  • Accepted 11 November 2007
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