Probiotics, calcium and acute diarrhea : a randomized trial in Indonesian children

摘要: Background Acute diarrhea and acute respiratory tract infections (ARTIs) continue to lead the infectious cause of morbidity mortality among children Methods We conducted a 6-month, double-blind, placebo-controlled trial. A total 494 Indonesian healthy aged 1 6 years randomly received low-lactose milk with low calcium content (LC; ∼50 mg/day; n = 124), regular (RC; ∼440 126), RC 5.108 colony-forming units per day Lactobacillus casei CRL 431 (casei; 120), or reuteri DSM 17938 (reuteri; 124). Incidence duration were primary outcomes. Secondary outcomes incidence ARTIs, severity (modified Vesikari score fecal osmolarity, calprotection mucin), growth, iron zinc status. The cross-sectional association between food-hygiene practices 7-day record period prevalence was assessed 274 selected 12-59 months in socioeconomic urban area Jatinegara sub-district East Jakarta, Indonesia. Results World Health Organization-defined (≥3 loose/liquid stools 24 hours) not significantly different LC (relative risk 0.99; 95% confidence interval (CI): 0.62-1.58), 1.21; CI: 0.76-1.92), 0.76; 0.46-1.25) groups. all reported (≥2 lower versus group 0.68; 0.46-0.99). Irrespective definition used, reduced nutritional status (below-median height-and-weight-for-age z score). None interventions affected ARTIs. mean (131 children, 190 diarrheal episodes) 1.35 days shorter 0.60; 0.36-0.99) 6-month period, likely by mainly affecting rotavirus-positive diarrhea. Rotavirus cases (30%) across supplements based on markers, except for higher mucin concentration (P .006). increase weight gain, weight-for-age (WAZ) changes monthly height velocities compared over whereas. L. casei, although giving less benefit, modestly improved velocity. Changes underweight stunting prevalence, anemia similar No serious adverse events related reported. Children living house clean sewage had those who did have one dirty (adjusted odds ratio 0.16; 0.03-0.73). overall practice associated group, but it Conclusion may prevent especially status, reduce episodes, improve growth months, does affect severity. improves velocity, incidence, However, seems too early recommend probiotics (e.g. reuteri) routine use follow-up public health programs developing countries. Milk alone any Moreover, none dietary treatments children. In addition other major determinants, poor mother’s contributes occurrence