In a study assessing the impact of the first national campaign to scale up zinc treatment of diarrhea in Bangladesh, researchers found that awareness was high but usage lagged behind. In this week's open access journal PLoS Medicine, Charles Larson and colleagues from International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) report the results of seven repeated ecologic surveys in four areas in Bangladesh, representing 1.5 million children under the age of 5.
The researchers found that awareness was less than 10% in all communities pre-launch and peaked 10 months later at 90, 74, 66 and 50% in urban non-slum, municipal, urban slum, and rural sites, respectively. After 23 months 25% of urban non-slum, 20% of municipal and urban slum, and 10% of rural children under 5 years were actually receiving zinc for childhood diarrhea. Use of zinc was found to be safe, with few side-effects, and did not affect the use of traditional treatments for diarrhea. The researchers also found that many children were not given the correct 10-day course of treatment: 50% of parents were sold seven or fewer zinc tablets.
The ''Scaling Up of Zinc for Young Children'' (SUZY) project, funded by the Bill & Melinda Gates Foundation, was established in 2003 to develop a scale-up campaign, produce and distribute zinc tablets, train health professionals to provide zinc treatment, and create media campaigns (such as adverts in TV, radio, and newspapers) to raise awareness and promote the use of zinc for diarrhea.
Diarrheal disease is a significant global health problem causing about 4 billion cases and 2.5 million deaths annually, and disproportionately affecting those in the developing world. Clinical trials show that zinc can help reduce the severity and duration of diarrhea as well as lower the likelihood of a repeat episode in the future. Zinc is now included in the guidelines by the World Health Organization (WHO)/UNICEF for treatment of childhood diarrhea.
Funding: This study was funded by the Bill & Melinda Gates Foundation, grant number 00231. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Larson CP, Saha UR, Nazrul H (2009) Impact Monitoring of the National Scale Up of Zinc Treatment for Childhood Diarrhea in Bangladesh: Repeat Ecologic Surveys. PLoS Med 6(11): e1000175. doi:10.1371/journal.pmed.1000175
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