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PENULIS

: Dominik Golicki et al

TAHUN

: 2016

JUDUL

: Meta-analysis: zinc supplementation for acute gastroenteritis


in children

JURNAL

: Alimentary Pharmacology & Therapeutics

HALAMAN

: 713-723

No
.
1

Kriteria
P
(Patient/Clinica
l Problem)

Jawa
b
Ya

Pembenaran & Critical thinking

I
(Intervention)

Ya

The problem in this journal is To review


evidence for the effectiveness of zinc in
treating acute gastroenteritis in children,
with special emphasis on data from
developed countries.
MEDLINE, EMBASE, and the Cochrane
Library
were
searched
through
November
2007
for
randomized
controlled trials (RCTs) relevant to acute
gastroenteritis in children younger than
5 years of age and zinc; additional
references were obtained from the
reviewed articles.
Studies appropriate for inclusion were
identified
by
searching
Medline
(PubMed), Embase (Ovid) and The
Cochrane Central Register of Controlled
Trials (CENTRAL) through November
2007. The search strategy employed a
combination of a validated filter for
identifying controlled trials with topicrelated keywords: zinc, diarrhoea,
diarrh*,
gastrit*,
gastroenteritis,
vomit*, child*, infant*, toddler*. The
Cochrane Highly Sensitive Search
Strategy filter was used to obtain
RCTS.8 Additionally, reference lists
from original studies and review articles
were obtained.
Two independent reviewers (BP and
DG) assessed the abstracts from the
clinical trials that were identified

C
(Comparasion)

Ya

O
(Outcome)

Ya

according to the search strategy and,


subsequently, the full texts of the
studies that seemed relevant. Both
reviewers independently carried out
data extraction and entered the data
into a computer program, The Cochrane
Review Manager [(RevMan) Version
5.0.: The Nordic Cochrane Centre, The
Cochrane
Collaboration
2007,
Copenhagen, Denmark], was used for
statistical analysis and to perform the
meta-analysis. The differences between
the reviewers were resolved by
discussion.
We used RevMan to perform statistical
analysis and
meta-analysis. The weighted mean
difference (WMD)
between the treatment and control
groups was selected
This review was initiated as part of the
development of the European guidelines for
the management of AGE in children to
update evidence for the effectiveness of
zinc in treating AGE in children, with special
emphasis on data from developed
countries.
Out of 43 clinical trials that were primarily
identified
as
assessing
zinc
supplementation in patients with acute
diarrhoea, 18 of them926 met the
inclusion criteria
Eighteen studies that met the inclusion
criteria recruited a total of 11 180
participants (6109 assigned to the
experimental group and 5071 assigned to
the control group) younger than 5 years of
age with acute diarrhoea.
Data regarding diarrhoea duration were
available from 16 studies. Only 13 of them
provided a measure of variance. A metaanalysis of 13 RCTs (5643 participants)
showed a significantly lower average
duration of diarrhoea for those treated with
zinc compared with placebo (WMD )0.69,
95% CI )0.97 to )0.40; Figure 1). The

included
trials
were
significantly
heterogeneous (v2 = 55.22, P < 0.00001; I2
= 78%).
Eighteen RCTs (11 180 participants, mainly
from developing countries) met the
inclusion criteria. Use of zinc was
associated with a significant reduction in
diarrhoea duration (13 RCTs, 5643 infants,
weighted mean difference )0.69 day, 95%
CI )0.97 to )0.40) and the risk of diarrhea
lasting longer than 7 days [eight RCTs, n =
5769, relative risk (RR) 0.71, 95% CI 0.53
0.96]. No significant reduction in stool
volume was observed for those receiving
zinc compared with placebo (three RCTs, n
= 606, standardized mean difference, )0.38,
95% CI )1.04 to 0.27). Combined data from
five RCTs (n = 3156) showed that zinc
significantly increased the chance of
vomiting compared to the control agent (RR
1.2, 95% CI 1.051.4).
These
data
confirm
that
zinc
supplementation can be useful for treating
acute gastroenteritis in children, particularly
those from developing countries. However,
the role of zinc supplements in treating
children with acute gastroenteritis in
developed
countries
needs
further
evaluation.