TY - JOUR
T1 - Effect of probiotics on diarrhea in children with severe acute malnutrition
T2 - A randomized controlled study in Uganda
AU - Grenov, Benedikte
AU - Namusoke, Hanifa
AU - Lanyero, Betty
AU - Nabukeera-Barungi, Nicolette
AU - Ritz, Christian
AU - Mølgaard, Christian
AU - Friis, Henrik
AU - Michaelsen, Kim F.
N1 - CURIS 2017 NEXS 069
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Objectives: The aim of the study was to assess the effect of probiotics on diarrhea during in-and outpatient treatment of children with severe acute malnutrition (SAM). Methods: A randomized, double-blind, placebo-controlled study was conducted involving 400 children admitted with SAM. Patients received 1 daily dose of a blend of Bifidobacterium animalis subsp lactis and Lactobacillus rhamnosus (10 billion colony-forming units, 50:50) or placebo during hospitalization followed by an 8-to 12-week outpatient treatment period, depending on patients' recovery rate. All outcomes were reported for in-and outpatient treatment separately. The primary outcomewas number of days with diarrhea during hospitalization. Secondary outcomes included other diarrhea outcomes, pneumonia, weight gain, and recovery. Results: There was no difference in number of days with diarrhea between the probiotic (n=200) and placebo (n=200) groups during inpatient treatment (adjusted difference +0.2 days, 95% confidence interval-0.8 to 1.2, P=0.69); however, during outpatient treatment, probiotics reduced days with diarrhea (adjusted difference +2.2 days 95% confidence interval-3.5 to-0.3, P=0.025). There were no effects of probiotics on diarrhea incidence and severity or pneumonia, weight gain or recovery during in-or outpatient treatment. Twenty-six patients died in the probiotic versus 20 in the placebo group (P=0.38). Conclusions: Bifidobacterium animalis subsp lactis and Lactobacillus rhamnosus had no effect on diarrhea in children with SAM during hospitalization, but reduced the number of days with diarrhea in outpatient treatment by 26%. Probiotics may have a role in follow-up of hospitalized children with SAM or in community-based treatment of malnourished children, but further studies are needed to confirm this.
AB - Objectives: The aim of the study was to assess the effect of probiotics on diarrhea during in-and outpatient treatment of children with severe acute malnutrition (SAM). Methods: A randomized, double-blind, placebo-controlled study was conducted involving 400 children admitted with SAM. Patients received 1 daily dose of a blend of Bifidobacterium animalis subsp lactis and Lactobacillus rhamnosus (10 billion colony-forming units, 50:50) or placebo during hospitalization followed by an 8-to 12-week outpatient treatment period, depending on patients' recovery rate. All outcomes were reported for in-and outpatient treatment separately. The primary outcomewas number of days with diarrhea during hospitalization. Secondary outcomes included other diarrhea outcomes, pneumonia, weight gain, and recovery. Results: There was no difference in number of days with diarrhea between the probiotic (n=200) and placebo (n=200) groups during inpatient treatment (adjusted difference +0.2 days, 95% confidence interval-0.8 to 1.2, P=0.69); however, during outpatient treatment, probiotics reduced days with diarrhea (adjusted difference +2.2 days 95% confidence interval-3.5 to-0.3, P=0.025). There were no effects of probiotics on diarrhea incidence and severity or pneumonia, weight gain or recovery during in-or outpatient treatment. Twenty-six patients died in the probiotic versus 20 in the placebo group (P=0.38). Conclusions: Bifidobacterium animalis subsp lactis and Lactobacillus rhamnosus had no effect on diarrhea in children with SAM during hospitalization, but reduced the number of days with diarrhea in outpatient treatment by 26%. Probiotics may have a role in follow-up of hospitalized children with SAM or in community-based treatment of malnourished children, but further studies are needed to confirm this.
KW - Faculty of Science
KW - Probiotic
KW - Diarrhea
KW - Severe acute malnutrition
KW - Young children
KW - Low-income country
U2 - 10.1097/mpg.0000000000001515
DO - 10.1097/mpg.0000000000001515
M3 - Journal article
C2 - 28079729
SN - 0277-2116
VL - 64
SP - 396
EP - 403
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
IS - 3
ER -
