Diarrhea is a significant cause of morbidity and mortality in children in developing countries, especially in children aged 6-24 months. The high incidence of diarrhea at that age is due to the reduced intake of breast milk and the provision of complementary feeding. Probiotics have been known as acute diarrhea therapy because they support the recovery phase of diarrhea mainly caused by viruses by increasing secretory IgA production and inhibiting viral multiplication. Probiotics also produce bacteriocin, which acts as a competitive inhibitor and reduces bacterial growth.
Heat-killed probiotic complex (HKPC) is a dosage form of probiotics that contains inactive probiotics and is more stable to heat and storage for a long time. Several studies have shown that HKPC has the same or better benefits than live probiotics for acute diarrhea in children, but not a few studies that show the opposite results. In this study, we aimed to observe the effects of HKPC probiotics on the duration and rate of recovery from acute diarrhea in children aged 6-24 months.
The number of samples in this study was 98 children with acute diarrhea who were hospitalized and then divided into two groups, the group that received HKPC and the control group (placebo). The duration of diarrhea and the rate of recovery of diarrhea was evaluated as outcomes in this study. The recovery rate of diarrhea is determined based on the frequency of bowel movements (BAB) and the consistency of feces which are classified into four namely 1) Level I if the consistency of solid stools is not more than three times per day; 2) Level II if the consistency of soft feces is not more than three times a day; 3) Level III if runny stool with lumps no more than three times a day; and 4) There is no recovery. Stool consistency was observed based on the Bristol stool chart. Observations were made for seven days. Children who had received probiotics, antibiotics, or zinc, and children with severe comorbidities or malnutrition were not included in this study.
The average age in this study was 11 months in both groups. Boys (53%) were presented in this study than girls. Rotavirus infection was found in more than half (53%) of children in this study. The time needed for the control group (4 days, range 2-7 days) to recover from diarrhea is not so different from the HKPC group (3 days, range 2-8 days). The recovery rate of diarrhea at levels I and II was also found to be no different from the first day to the last day (day 7) observed in this study.
These results indicate that the HKPC probiotic failed to increase the rate of recovery in treating acute diarrhea in children aged 6-24 months. Previous studies have shown mixed results. The duration of diarrhea was not different. However, HKPC probiotics are compared with active probiotics. Another study found that HKPC probiotics did indeed shorten the duration of diarrhea and shorten the length of stay compared to live probiotics, but not the frequency of stool. Some of these studies assess the rate of recovery of diarrhea based on frequency (time/day) and duration of diarrhea (hours) to avoid bias in the study. In contrast, in this study, bias can be reduced by evaluating the consistency of feces by using the Bristol stool chart.
From this study, it is known that HKPC probiotics do not have a significant effect on the duration and rate of recovery of diarrhea in children aged 6-24 months with acute diarrhea. Further research, especially on the recovery rate of diarrhea, which is judged by the consistency of feces, needs to be done. (*)
Author: IGN Reza Gunadi Ranuh
Link
http://chimie-biologie.ubm.ro/carpathian_journal/Papers_11(5)/CJFST11(5)2019.pdf
