Based on the results of a large number of randomized controlled trials that have demonstrated the therapeutic benefits of zinc supplementation during diarrhea, WHO and UNICEF have recommended the use of zinc supplementation at a dose of approximately 2RDAs per day (10-20 mg) for 10-14 days. This strategy has the advantage of having a good delivery mechanism (i.e., during the delivery of ORS packets). The effectiveness of different delivery strategies is being evaluated in large-scale trials.
A study from India evaluated the efficacy of zinc-fortified ORS and reported that zinc-ORS was moderately efficacious in reducing the severity of acute diarrhea. If these results are confirmed by other studies, this strategy has the advantage of reducing the need to deliver the zinc supplementation separate from the ORS packets. However, it will probably result in increased cost of ORS production and not all countries will be able to rapidly scale up the production of zinc-ORS in the near future. Additional potential disadvantages of this strategy are that coverage with ORS is low, ORS is usually needed only for 2 or 3 days, and the volume of ORS taken is generally low. Therefore, it will be difficult to ensure adequate zinc intake.
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