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Randomised controlled trial
Is there a real benefit to zinc and prebiotic fortified ORS in children under the age of 3 years?
  1. Christa L Fischer Walker
  1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Correspondence to: Christa L Fischer Walker
    Johns Hopkins Bloomberg School of Public Health, Room E5608, 615 North Wolfe Street, Baltimore, MD 21205, USA; cfischer{at}

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Implication for practice and research

  • Zinc supplementation as an adjunct therapy to oral rehydration solution (ORS) has been shown to reduce duration and severity of the diarrhoea episode among children <5 years of age in low- and middle-income countries.

  • Zinc-fortified ORS should not take the place of zinc in addition to ORS in low- and middle-income countries.

  • Additional research is needed before ‘super ORS’ should be recommended as a treatment in high-income countries which should include studies comparing efficacy and cost of zinc alone plus ORS with the combined zinc, ORS and prebiotic treatment.


Diarrhoea continues to be the second leading cause of death among children below 5 years of age around the world.1 Zinc-fortified ORS solution has been shown to be efficacious in decreasing stool frequency and proportion of episodes extending beyond 7 days when investigated in young …

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  • Competing interests None.