Serum zinc levels in children with kwashiorkor aged\one to three years at Kenyatta National Hospital and the effect of zinc supplementation during recovery

Abstract

Eighty two children w\ith kwashiorkor were investigated to determine serum zinc concentrations at the time of admission and these levels were compared to those of 49 normal children (group A) matched for age. The role / of early zinc supplemetation on accelerating the

improvement of some clinical features of kwashiorkor namely oedema, diarrhoea, anorexia and skin ulcerations was also investigated, by comparing two groups. "Th ere were 42 kwashiorkor patients who received zinc supplementation (group B) and 40 kwashiorkor patients who were not supplemented (group C) •

The mean weight of the kwashiorkor patients was 8.0kg -. r and that of the control group was 11.3kg.. The mean

'serum zinc concentration was 6.4 u~ol/L in the / kwashiorkor group and 12.9 umol/L in the control group. There was a significant difference between these two levels. (P<0.05). 98.8% of the kwashiorkor patients had low serum zinc while all the children in the control group had normal serum zinc.

The treatment group B was given zinc sulphate solution at a dose of approximately 5mg'elemental zinc/Kg body weight/day in three divided doses. The control qrouD C received no supplemental zinc but both groups of

patients received identical nutritional and other

medical care. <pa t i.ent s at

Serum zinc was determined again in all

10 days of treatment/when none of the

patients in both groups was found to have achieved normal serum zinc.

The duration of oedema,• diarrhoea, anor~xia, and skin' ulcerations was shortened by 2, 7, 4 and 3 days respectively by ~inc supplementation in group B. This difference was significant statistically

(p ~alves of <p.OS, ~O.ODl" <0.01 and <0.03) respectively.

2

The average rat~ of weight gain was also greater

67gm/day in group B compared to 47 .3gm in group C. However, despite faster re~overy from the above clinical features, zinc supplementation had no effect on duration of stay in hospit~l. The difference was not significant (p>O.05).