Objective: The
study aimed to assess the efficacy of probiotics in the context of acute watery
Diarrhoea and their effects on serum immunoglobulin in children.
Background:
Diarrheal disease is responsible for a substantial health-related burden on
human society and remains the second leading cause of death in children below 5
years of age. The use of probiotics has gained increased popularity, even
though the concept of using probiotics for the prevention and treatment of some
human illnesses has been around for over a century.
Methods: This
study was performed as a parallel-group, interventional non-randomized study
with enrollment of pediatric patients according to eligibility criteria and
being allocated to receive probiotic therapy in Uttara Adhunik Medical College,
and allocated to receive probiotics, antibiotics, or probiotics + antibiotics
for 30 days in accordance with the standard treatment protocol of Diarrhoea.
Clinical outcome measurements included the duration of Diarrhoea and treatment
of adverse events. Stool culture and blood immunoglobulin were analyzed on days
0 and 30.
Results: A total
of 166 enrolled children were divided into three groups: Group A (probiotics),
Group B (antibiotics) and Group C (probiotics + antibiotics) with 98
participants returning for a follow-up visit on day 30. All groups were
comparable in their baseline characteristics. Causative organisms of Diarrhoea
among final participants (N=98) were Rotavirus (69.4%), E. Coli (67.4%),
multiple organisms (2 or more) (45.9%), Campylobacter (34.7%), Vibrio cholerae
(20.4%), Salmonella (10.2%), Shigella (9.2%), and Klebsiella (1.0%). The
fastest recovery occurred in Group A (3.03 ± 0.76 days; Group C: 3.80 ± 1.10
days; Group B: 4.11 ± 1.48 days; p=0.001). At follow-up, administration of
probiotics was associated with the presence of commensal Lactobacillus and
Bifidobacterium in stool. Randomized controlled trials that incorporate
probiotics in the treatment of Diarrhoeal diseases may potentially lead to
improved utilization of the traditional and virtually universally applied antimicrobial
chemotherapy in Bangladesh. Probiotics may also provide effective prevention of
Diarrhoea, as illustrated by the increased serum levels of immunoglobulins.
Conclusion: The
inclusion of probiotics for the treatment of acute watery Diarrhoea in children
is effective, and safe and results in a shorter duration of Diarrhoea and
faster discharge from the hospital. Probiotics may provide future alternative
prevention and treatment strategies for childhood Diarrhoeal diseases in
Bangladesh.
Author(s)details:-
Abu Syed Md. Mosaddek
Department of Pharmacology, Uttara Adhunik Medical College, Clinical Trial
Affairs, Quest, Bangladesh and Clinical Trial Affairs, Quest Bangladesh,
Bangladesh.
M. Rinat Rizvi
Purnova Limited, Dhaka, Bangladesh.
Rumi Akter
Quest Bangladesh, Bangladesh.
Md. Saiful Islam
Non-Communicable Diseases, Health System and Population Studies Division,
ICDDRB, Dhaka, Bangladesh.
Hrishik Iqbal
Department of Pharmacy, BRAC University, Dhaka, Bangladesh.
David Gazal
Department of Child Health, Pediatrician-in-Chief, MU Women’s and
Children’s Hospital, Columbia, United States.
Md. Salequl Islam
Department of Microbiology, Jahangirnagar University, Savar, Dhaka,
Bangladesh.
Fatima Farhana
Department of Pharmacology, Uttara Adhunik Medical College, Clinical Trial
Affairs, Quest, Bangladesh.
Please See the book
here :- https://doi.org/10.9734/bpi/mria/v3/180
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