Investigating the effect of ORS with probiotics, zinc and vitamin A on children’s diarrhea: a randomized clinical trial

• Abbas Taghavi Ardakani ^[1] ; Rahmat Yahyapour ^[1] ; Masoud Amiri ^[2] ; Mohammad Reza Sharif ^[1] ; Davood Khairkhah ^[1] ; Mohsen Taghizadeh ^[1] ; Hamid Reza Gilasi ^[1]
  1. [1] Kashan University of Medical Sciences

     Kashan University of Medical Sciences

     Irán

     
  2. [2] Shahrekord University of Medical Sciences

     Shahrekord University of Medical Sciences

     Irán

     
• Localización: Academic Journal of Health Sciences: Medicina Balear, ISSN-e 2255-0560, Vol. 37, Nº. 2, 2022, págs. 73-79
• Idioma: inglés
• DOI: 10.3306/AJHS.2022.37.02.73
• Títulos paralelos:
  • Investigación del efecto de las SRO con probióticos, zinc y vitamina A en la diarrea infantil: un ensayo clínico aleatorizado
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Antecedentes: La diarrea es una de las principales causas de muerte en los países en desarrollo. Debido a la interacción de la diarrea y la malnutrición entre sí, así como el papel de la malnutrición en los trastornos del desarrollo de los niños, la mejora de los programas de tratamiento de la diarrea de la diarrea desempeña un papel importante en la salud de los niños. Nuestro objetivo en este estudio era evaluar el efecto de las SRO con probióticos, zinc y vitamina A en la diarrea infantil.

    Métodos: En este estudio de ensayo clínico, los niños de 9 meses a 5 años fueron remitidos al Hospital Shahid Beheshti de Kashan con una queja de diarrea acuosa aguda en 2017-2018. Los niños fueron divididos aleatoriamente en cinco grupos. En estos grupos, los pacientes con gluconato de zinc fueron tratados con 20 mg de omental con SRO, vitamina A 20000 unidades con SRO, probiótico UFC con SRO, gluconato de zinc vitamina A y probiótico con SRO y, por último, sólo se trató con SRO. Luego, durante la visita diaria, se evaluó el estado de los pacientes en diarrea continua y el número de veces que tuvieron diarrea durante las últimas 24 horas y se registró en los cuestionarios. A continuación, los resultados se introdujeron en el programa informático SPSS17 y se analizaron según los métodos estadísticos correspondientes.

    Resultados: Todos los grupos de intervención fueron similares y comparables en cuanto a las características de género (p = 0,052), edad (p = 0,871) y peso (p = 0,958). La duración de la diarrea tras la intervención en el grupo combinado disminuyó significativamente (p <0,001) y en el grupo de SRO sólo aumentó significativamente (p = 0,013). La frecuencia de la diarrea disminuyó significativamente después de la intervención en todos los grupos (p <0,001). En el grupo combinado, el número de diarreas y la duración de la estancia hospitalaria disminuyeron significativamente.

    Conclusiones: Los resultados del presente estudio mostraron que el grupo de niños que recibió suplementos de zinc, vitamina A, pro- bióticos y SRO tuvo una disminución significativa del número de veces de diarrea y de la duración de la misma, así como de la duración de la hospitalización.

  • English

    Background: Diarrhea is one of the leading causes of death in developing countries. Due to the interaction of diarrhea and malnutrition on each other, as well as the role of malnutrition in children’s developmental and developmental disorders, improving diarrhea treatment programs plays an important role in children’s health. Our aim in this study was to evaluate the effect of ORS with probiotics, zinc and vitamin A on children’s diarrhea.

    Methods: In this clinical trial study, children aged 9 months to 5 years were referred to Shahid Beheshti Hospital in Kashan with a complaint of acute watery diarrhea in 2017-2018. The children were randomly divided into five groups. In these groups, patients with zinc gluconate were treated with 20 mg of omental with ORS, vitamin A 20000 units with ORS, CFU probiotic with ORS, zinc gluconate, vitamin A and probiotic with ORS and finally ORS were treated only they got. Then, during the daily visit, the condition of the patients in terms of continuing diarrhea and the number of times diarrhea was asked to their mother during the last 24 hours and was recorded in the questionnaires. Then the results were entered in SPSS17 software and analyzed according to related statistical methods.

    Results: All the intervention groups were similar and comparable in terms of gender characteristics (p = 0.052), age (p = 0.871) and weight (p = 0.958). The duration of diarrhea after intervention in the combined group decreased significantly (P <0.001) and in the ORS group only increased significantly (p = 0.013). The frequency of diarrhea decreased significantly after intervention in all groups (P <0.001).

    In the combined group, the number of diarrhea and the length of hospital stay decreased significantly.

    Conclusion: The results of the present study showed that the group of children receiving zinc supplements, vitamin A, probiotics and ORS had a significant decrease in the number of times diarrhea and the duration of diarrhea and the duration of hospitalization.

• Referencias bibliográficas
  • Bern C, Martines J, De Zoysa I, Glass R. The magnitude of the global problem of diarrhoeal disease: a ten-year update. Bulletin of the world health...
  • Moradi G, Khazaei Z, Esmailnasab N, Roshani D, Zokaii M, Ghaderi E, et al. The relationship between maternal diseases during pregnancy and...
  • El-Khoury M, Banke K, Sloane P. Improved childhood diarrhea treatment practices in Ghana: a pre-post evaluation of a comprehensive private-sector...
  • Zhang S-X, Zhou Y-M, Xu W, Tian L-G, Chen J-X, Chen S-H, et al. Impact of co-infections with enteric pathogens on children suffering from...
  • Niehaus MD, Moore SR, Patrick PD, Derr LL, Lorntz B, Lima AA, et al. Early childhood diarrhea is associated with diminished cognitive function 4...
  • Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, et al. Global burden of childhood pneumonia and diarrhoea. The Lancet. 2013;381(9875):1405-16.
  • Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic...
  • Organization WH. The treatment of diarrhoea: a manual for physicians and other senior health workers: World Health Organization; 2005.
  • Gould LH, Walsh KA, Vieira AR, Herman K, Williams IT, Hall AJ, et al. Surveillance for foodborne disease outbreaks—United States, 1998– 2008....
  • Long KZ, Rosado JL, DuPont HL, Hertzmark E, Santos JI. Supplementation with vitamin A reduces watery diarrhoea and respiratory infections...
  • Rodeheffer C, Von Messling V, Milot S, Lepine F, Manges AR, Ward BJ. Disease manifestations of canine distemper virus infection in ferrets...
  • Kossmann J, Nestel P, Herrera M, Amin A, Fawzi W. Undernutrition in relation to childhood infections: a prospective study in the Sudan. European...
  • Ross A, Caballero B, Cousins R, Tucker K, Ziegler T, Katherine Camacho Carr C. Modern nutrition in health and disease (Modern Nutrition in...
  • Arora R, Kulshreshtha S, Mohan G, Singh M, Sharma P. Estimation of serum zinc and copper in children with acute diarrhea. Biological trace element...
  • Al-Sonboli Na, Gurgel RQ, Shenkin A, Hart CA, Cuevas LE. Zinc supplementation in Brazilian children with acute diarrhoea. Annals of tropical...
  • Baqui AH, Black RE, El Arifeen S, Yunus M, Chakraborty J, Ahmed S, et al. Effect of zinc supplementation started during diarrhoea on morbidity...
  • Gregorio GV, Dans LF, Cordero CP, Panelo CA. Zinc supplementation reduced cost and duration of acute diarrhea in children. Journal of clinical epidemiology....
  • Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Sao Paulo Medical Journal. 2011;129(3):185.
  • Boirivant M, Strober W. The mechanism of action of probiotics. Current opinion in gastroenterology. 2007;23(6):679-92.
  • urawicz CM. Probiotics, antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in humans. Best Practice & Research Clinical...
  • Dehkordi FS, Saberian S, Momtaz H. Detection and segregation of Brucella abortus and Brucella melitensis in aborted bovine, ovine, caprine,...
  • Dehkordi FS, Momtaz H, Doosti A. Application of Real-Time PCR for detection of Aspergillus species in aborted ruminant foetuses. Bulgarian Journal...
  • Dehkordi FS. Prevalence study of Coxiella burnetii in aborted ovine and caprine fetuses by evaluation of nested and real-time PCR assays. American...
  • Safarpordehkordi F, Yahaghi E, Khodaverdi Darian E. Prevalence of antibiotic resistance in Escherichia coli isolated from poultry meat supply in...
  • Dehkordi FS, Tavakoli-Far B, Jafariaskari S, Momtaz H, Esmaeilzadeh S, Ranjbar R, Rabiei M. Uropathogenic Escherichia coli in the high vaginal...
  • Sharif A, Sharif M. The effect of bacterial and yeast probiotics on acute watery diarrhea in children. Iranian Journal of Pediatrics. 2014;24(S2):S40.
  • Farthing MJ. Novel targets for the pharmacotherapy of diarrhoea: a view for the millennium. Journal of gastroenterology and hepatology. 2000;15:G38-G45.
  • Drago L, De Vecchi E, Nicola L, Colombo A, Gismondo M. Microbiological evaluation of commercial probiotic products available in Italy. Journal...
  • Rosado JL, Lopez P, Morales M, Munoz E, Allen LH. Bioavailability of energy, nitrogen, fat, zinc, iron and calcium from rural and urban Mexican diets....
  • Szajewska H, Setty M, Mrukowicz J, Guandalini S. Probiotics in gastrointestinal diseases in children: hard and not-so-hard evidence of efficacy....
  • Kurugöl Z, Koturoğlu G. Effects of Saccharomyces boulardii in children with acute diarrhoea. Acta Paediatrica. 2005;94(1):44-7.
  • Grotto I, Mimouni M, Gdalevich M, Mimouni D. Vitamin A supplementation and childhood morbidity from diarrhea and respiratory infections: a...
  • Fawzi WW, Mbise R, Spiegelman D, Fataki M, Hertzmark E, Ndossi G. Vitamin A supplements and diarrheal and respiratory tract infections among...
  • Baqui AH, Black RE, Arifeen SE, Yunus M, Zaman K, Begum N, et al. Zinc therapy for diarrhoea increased the use of oral rehydration therapy and...
  • Long KZ, Montoya Y, Hertzmark E, Santos JI, Rosado JL. A double-blind, randomized, clinical trial of the effect of vitamin A and zinc supplementation...
  • Rosado JL, Lopez P, Muñoz E, Martinez H, Allen LH. Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected...
  • Prasad AS, Beck F, Grabowski SM, Kaplan J, Mathog RH. Zinc deficiency: changes in cytokine production and T-cell subpopulations in patients...
  • Velázquez FR, Garcia-Lozano H, Rodriguez E, Cervantes Y, Gómez A, Melo M, et al. Diarrhea morbidity and mortality in Mexican children: impact...
  • Schlaak J, Nieder P, zum Büschenfelde K-HM, Fleischer B. Human T helper cells reactive with somatic bacterial antigens belong to the Th1 subset....