International Trends in Zinc Treatment for Diarrhea.

Background: Diarrhea is a leading cause of death among children <5 years of age and can have long-term adverse consequences for human development. The World Health Organization has recommended the therapeutic use of zinc for the treatment of diarrhea, along with oral rehydration solutions, since 2004. We studied recent trends in the use of zinc to treat diarrhea in 23 low- and middle-income countries.

Methods: A repeated cross-sectional design of 46 Demographic and Health Surveys from 23 countries was used to estimate the average annual change in zinc treatment across recent years. The earlier surveys were conducted in different years from 2009 to 2014, and the latest surveys were conducted in different years from 2015 to 2023, with an average gap of 6 years between surveys. A diarrhea episode during the 2 weeks before the survey and the treatment of diarrhea using zinc and oral rehydration solutions among children <5 years old was identified using an interview with mothers.

Results: In the pooled sample, the treatment of diarrhea in children <5 years of age using zinc increased from 2% in the earlier surveys to 27% in the more recent surveys, or an average annual increase of 4 percentage points (pp). The prevalence of zinc treatment increased in all 23 countries, ranging from 9 pp per year on average in Sierra Leone to 1 pp in Cambodia.

Conclusions: A large increase in the use of therapeutic zinc to treat diarrhea in children was observed in recent years. However, coverage remains incomplete.