CROSS-SECTIONAL STUDY OF SERUM ZINC LEVELS IN CHILDREN WITH ACUTE GASTROENTERITIS IN A TERTIARY CARE HOSPITAL

Abstract

BACKGROUND: Acute gastroenteritis is one of the most important causes of childhood mortality and morbidity. The annual death rate in the world due to diarrhea in under-five children is 1.5-2.5 million. Deaths due to diarrhea in India is estimated at about 3.4lakh per year. In the year 1992, WHO and UNICEF recommended the use of zinc along with ORS for the treatment of diarrhea. Zinc is a ubiquitous trace element essential for mucosal integrity, skeletal growth and gut immunity and absorption of sodium and water. Zinc is absorbed in the small intestine; zinc absorption is inhibited by dietary fiber and phytates present in cereals and legumes. A balanced diet is essential to maintain normal zinc levels. Zinc also plays a role with protease and polymerase as a cofactor and helps in many cellular functions like wound healing and intestinal epithelial cell regeneration In developing countries, the incidence of children suffering from acute gastroenteritis is worsening due to illiteracy, malnutrition and infection. Zinc losses increase significantly during an episode of diarrhea in infants and are associated with negative zinc balance. There is a mutual dependence seen between diarrhea and zinc deficiency. As zinc deficiency causes diarrhea, diarrhea leads to zinc deficiency. OBJECTIVES: 1. To determine serum zinc levels in a patient having acute gastroenteritis attending to tertiary care hospital. 2. To correlate the serum zinc levels with severity of diarrhea, nutritional status in children having acute gastroenteritis. XII MATERIAL AND METHODS: Conducted a cross-sectional study in the Pediatrics deapartment at Sri Devaraj Urs Medical College, Tamaka, Kolar for a period of one year from January 2019 to December 2019. RESULTS: In total we have recruited 120 children. Age distribution of the study participants was 6 months to 60 months. Around 17.5% of the study population had severe dehydration. The mean serum zinc level identified was 9.71 ± 3.88μmole/L.Statistically significant weak negative correlationwas observed betweenthe level of dehydration and serum zinc levels. The trend of decrease in the levels of mean serum zinc with an increase in the severity of dehydration was statistically significant. The mean “serum zinc level” was higher at 11.47 micro mole/L in no dehydration group compared to severe dehydration with 88 ± 2.65 micro mole/L. The negative correlation betweenthe degree of malnutrition and “serum zinc level” was weak and was statistically significant. CONCLUSION: The present study estimated the association between the serum zinc level, severity of diarrhea and dehydration status.