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Sur et al (2010) Role of probiotic in preventing acute diarrhoea in children: a community-based, randomized, double-blind placebo-controlled field trial in an urban slum

Sur et al (2010) Role of probiotic in preventing acute diarrhoea in children: a community-based, randomized, double-blind placebo-controlled field trial in an urban slum

Citation

Sur D, Manna B, Niyogi SK, Ramamurthy T, Palit A, Nomoto K, Takahashi T, Shima T, Tsuji H, Kuakawa T, Takeda Y, Nair GB, Bhattacharya SK (2010). Role of probiotic in preventing acute diarrhoea in children: a community-based, randomized, double-blind placebo-controlled field trial in an urban slum. Epidemiology & Infection 139(6):919-26.

NOTE: reprint available on request. Email science@yakult.co.uk

Objective

Acute diarrhoea is a major cause of death for infants and young children in developing countries. In addition to hygiene-promoting strategies (safe drinking water, sanitation, hand washing), there is a perceived need to develop alternative strategies for reducing this risk. The objective of the study was to investigate whether a daily probiotic could reduce incidence of acute diarrhoea in young children living in poor conditions.

Methods

The double-blind, placebo-controlled, randomised study involved 3758 children aged one to five years old, living in an urban slum community in Kolkata, India. Every day for 12 weeks, the volunteers consumed either a probiotic (65ml fermented milk drink containing 6.5 x 109 Lactobacillus casei Shirota; LcS) or a placebo drink of similar nutrient content, taste and appearance. The effects of these interventions were assessed during the drinking period and for a further 12 weeks.

The primary outcome was the occurrence of the first episode of diarrhoea for an individual during this time (as recorded by community health workers with a pre-tested questionnaire). Further analyses included identification of pathogens from stool samples and anthropometric measurements.

Results

After 24 weeks, the incidence of diarrhoea in the probiotic group was 608 (i.e. 0.88 cases/child per year) compared to 674 for the placebo group (1.029 cases/child per year). This was equivalent to a probiotic reduction of the risk of diarrhoea by 14% (95% confidence interval 4-23, P < 0.01 in adjusted model).

Microbial analysis found a range of pathogens in the stools, and the probiotic effect could not be attributed to any particular aetiology. The only statistically significant finding from the microbial analysis related to detection of species of Aeromonas and Cryptosporidium at a lower rate in faeces of those drinking probiotic compared to the placebo.

Anthropometric measurements were similar between the groups.

Conclusions

The authors concluded that these data suggest that daily probiotic intake could help in preventing episodes of acute diarrhoea in young children living in this type of community in a developing country.

 
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