Zinc Supplementation in Thai Children with Dengue Fever

Background: Zinc deficiency is common in developing countries and increases the risk for several infectious diseases. Low serum zinc levels have been reported in children with dengue virus infection (DVI).

Objective: To assess the effects of zinc supplementation on DVI outcomes.

Methods: A double blinded, randomized trial was conducted in children with dengue fever (DF)/ dengue haemorrhagic fever (DHF). Bis-glycinate zinc or placebo was orally administered 3 times a day for 5 days or until defervescence. Primary outcome was to evaluate the DVI defervescence phase; secondary outcome was to assess hospitalization length, presences of severe DVI and zinc deficiency.

Results: Fifteen children with DHF and 35 with DF were randomized 1:1. Overall prevalence of zinc deficiency was 46%. Serum zinc levels increased from baseline to the end of study: the mean gain was 26.4 mg/dL (95%CI: 13.6 to 39.1 mg/dL) in the supplementation group and 14.4 mg/dL (95%CI: 7.4 to 21.3 mg/dL) in placebo group. Mean time of defervescence was not significant different between groups (29.2±24.0 and 38.1±31.5 hours; P-value=0.270). Hospital staying was shorter for children with zinc supplementation than for those with placebo (mean difference 22.2 hours, 95%CI: 5.5 to 38.5 hours; P-value= 0.010). No signs of severe DVI were observed in both groups. Zinc supplementation was well tolerated.

Conclusion: Overcoming zinc deficiency among Thai children may reduce DF duration and limit the hospitalization, in addition to other advantages that normal serum zinc levels have on overall children health.