Zinc gluconate 50mg tablets

ContextThe assessment of zinc status is difficult but essential for the identification of zinc deficiency and evaluation of interventions to improve zinc status.ObjectiveThe purpose of this systematic review (SR) and meta-analysis was to update the previously published SR of biomarkers of zinc status, conducted by the European Micronutrient Recommendations Aligned (EURRECA) network in 2009, to answer the question: Which putative measures (biomarkers) of zinc status appropriately reflect a change in zinc intake of at least 2 weeks?Data sourcesA structured search strategy was used to identify articles published between January 2007 and September 2022 from MEDLINE (Ovid), Embase (Ovid), Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles were identified using previously defined eligibility criteria.Data extractionData were extracted and combined with data from the previous SR.Data analysisA random-effects model was used to calculate pooled mean differences using STATA (StataCorp). The risk of bias and the certainty of evidence for all outcomes were assessed. Additional data on 7 of the 32 previously reported biomarkers were identified, along with data on an additional 40 putative biomarkers from studies published since 2007. Pooled data analysis confirmed that, in healthy participants, both plasma/serum zinc concentration and urinary zinc excretion responded to changes in zinc intake (plasma/serum: mean effect [95% CI], controlled studies: 2.17 µmol/L [1.73, 2.61]; P ConclusionThe updated analyses support the conclusion that plasma/serum and urinary zinc respond to changes in zinc intake in studies of healthy participants. Several additional putative biomarkers were identified, but more studies are needed to assess the sensitivity and reliability.Systematic review registrationPROSPERO no. CRD42020219843.

Abstract licence: CC BY

Zinc supplementation is a critical adjunct therapy for managing acute childhood diarrhoea, particularly in low-income countries (LICs) and lower middle-income countries (LMICs). However, adherence to the recommended zinc regimen remains a major challenge, limiting its effectiveness in real-world settings. This systematic review and meta-analysis aimed to estimate the pooled adherence rates to zinc supplementation for diarrhoea in children under 5 and identify key determinants of adherence. A comprehensive search of PubMed, Embase, Scopus, Google Scholar, ProQuest, and CINAHL was conducted between 2000 and 2024. A total of 10 observational studies were included, with pooled adherence of 63.45% (95% CI: 51.62-75.28) for 10 days regimen and 34.58% (95% CI: 7.08-62.09) for 14 days regimen, along with high heterogeneity. Sensitivity analysis confirmed robustness of these estimates. Key factors associated with adherence included caregiver education, provider counselling, medication acceptability, and economic constraints related to caregiver buying capacity. Doi plot asymmetry suggested possible publication bias for 10 and 14 days regimen. Overall, adherence to zinc therapy remains sub-optimal, particularly for 14 days regimen compared to 10 days regimen. Targeted interventions addressing behavioural, provider, and formulation related barriers are urgently needed to optimize zinc adherence and improve diarrhoea outcomes globally.

Abstract licence: CC BY-NC-ND