Diarrhoea is a leading cause of illness and death among children in developing countries where an estimated four million deaths occur each year in under-five aged children. Zinc deficiency has been found to be widespread among children in developing countries and occurs in most of Latin America, Africa, the Middle East and South Asia.
In Asia, a number of studies and trials have been carried out in India, Bangladesh, Nepal, Indonesia in the last eight years, according to medical experts.
Treatment of acute diarrhoea has relied upon therapy of oral rehydration. More recent advances in the science of diarrhoea treatment include recognition for the role of zinc supplementation in reducing disease severity and occurrence and development of an oral rehydration solution (ORS).
The combination of oral rehydration and early nutritional support with zinc has proven effective throughout the world in treating acute diarrhoea, according to medical experts. A number of trials have supported zinc supplementation as an effective agent in treating and preventing diarrhoeal disease. Further evidence is required for qualifying the use of zinc supplementation in treatment of other infective diseases like pneumonia and malaria.
WHO constituted a Task Force consisting of a group of experts which met in New Delhi in May 2001. The task Force concluded that zinc supplementation give at a dose of about 10 to 20 mg per day for 14 days is efficacious in significantly reducing severity of diarrhoea as well as duration of the episode. Further research to determine the effect of zinc supplementation in young infants was also recommended.
A national Task Force constituted by Indian Academy of Paediatrics (IAP) recommended in August 2003 that a uniform dose of 20 mg of elemental zinc should be given during the period of diarrhoea and for seven days after cessation of diarrhoea to children older than three months. Iron containing formulations should not be used with zinc as iron interferes with zinc absorption.
There seem to be disparity in dosage and treatment suggested for specific age of children in the recommendations made by WHO and IAP. Another major concern for India is lack of laboratories that can test zinc deficiency, the experts noted.
Dr HPS Sachdev of IAP told Pharmabiz that an IAP Task Force on Diarrhoea is planning to meet and review existing guidelines on May 6 and 7, 2006. IAP is aiming at initiating measures that will facilitate reduction in child mortality rate.
Multi-centric trials can determine the efficiency of zinc in controlling the disease and Indian pharma companies have already stepped into this direction. As per estimates, the ant-diarrhoeal market in India is about Rs 110 crore and ORS segment constitutes about Rs 66 crore.