Adherence to Zinc Therapy in Under-Five Children With Acute Diarrhea and Its Association With Clinical Recovery

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Published: 2026-03-30
DOI: https://doi.org/10.61919/pdphh484
Keywords:
Acute diarrhea; zinc supplementation; adherence; under-five children; clinical recovery; recurrence; caregiver awareness; Pakistan.

Main Article Content

Abdul Wasay
Continental Medical College, Lahore, Pakistan
Dr. Muhammad Mohsin Shoukat
Consultant Pediatrician, THQ Hospital Hasilpur, District Bahawalpur, Pakistan
Summiya Kiyani
Doctor of Pharmacy, Riphah International University, Islamabad, Pakistan
Malahat Sohaib
Senior Registrar, Department of Pediatrics, Memon Medical Institute Hospital, Karachi, Pakistan
Hina Ali Ahmed
Assistant Professor, Sardar Bahadur Khan Womens University, Quetta, Pakistan
Dr. Muhammad Hassaan Ali Shah
Medical Officer, Maryam Nawaz Health Clinic Chakral, Chakwal, Pakistan

Abstract

Background: Acute diarrhea remains a major cause of morbidity among children under five, and zinc supplementation is recommended as an adjunct to oral rehydration therapy; however, incomplete adherence may reduce its real-world clinical benefit. Objective: To determine adherence to the prescribed 10-day zinc supplementation regimen among children aged 6–59 months with acute diarrhea and evaluate its association with clinical recovery and 14-day recurrence. Methods: This prospective cohort study enrolled 220 children presenting with acute diarrhea at a tertiary-care pediatric setting in Lahore, Pakistan. Children received oral zinc according to standard pediatric recommendations and were followed for 14 days. Adherence was categorized as full, partial, or non-adherence. Outcomes included diarrhea duration, stool consistency improvement by day 4, recurrence within 14 days, and caregiver-reported barriers. Results: Full adherence was observed in 142 children (64.5%), partial adherence in 54 (24.5%), and non-adherence in 24 (10.9%). Mean diarrhea duration increased from 2.9 ± 0.8 days in fully adherent children to 4.1 ± 1.2 days in partially adherent and 5.3 ± 1.5 days in non-adherent children. Stool consistency improved by day 4 in 78.2%, 51.9%, and 33.3%, respectively, while recurrence occurred in 6.3%, 11.1%, and 20.8%. Poor palatability, vomiting, forgetfulness, and medicine unavailability were the main barriers. Conclusion: Full adherence to zinc supplementation was associated with faster recovery and lower recurrence. Strengthened counseling, child-friendly formulations, reminder systems, and reliable zinc availability may improve adherence.

Article Details

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Vol. 4 No. 6 (2026)

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Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

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1.
Abdul Wasay, Dr. Muhammad Mohsin Shoukat, Summiya Kiyani, Malahat Sohaib, Hina Ali Ahmed, Dr. Muhammad Hassaan Ali Shah. Adherence to Zinc Therapy in Under-Five Children With Acute Diarrhea and Its Association With Clinical Recovery. JHWCR [Internet]. 2026 Mar. 30 [cited 2026 Jun. 26];4(6):1-12. Available from: https://jhwcr.com/index.php/jhwcr/article/view/1703

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