Prevention Of Acute Diarrhea Research Articles

Use Of Guava As A Prevention Of Acute Diarrhea In Toddlers

The 2018 Balitbangkes Basic Health Research (Riskesdas) data shows the prevalence of diarrhea in toddlers is 12.3%. Riskesdas also stated that the most common cause of infant death was diarrhea (31.4%). According to the 2010 diarrhea morbidity survey, the largest proportion of sufferers was in the 6-11 month age group, which was 21.65% (Ministry of Health, 2011). This study aims to get an overview of the use of guava leaves as an effort to prevent acute diarrhea in toddlers.The method used in this study is quantitative, which is to find out an accurate description of the use of guava as an effort to prevent acute diarrhea in toddlers.From the results of the study it was found that most children who experienced diarrhea consumed guava as an alternative treatment by 60%.Giving decoction of guava leaves effective in reducing the frequency of diarrhea when consumed regularly, besides that it can used by the community as traditional medicine that has easy profit, easy way its use, and many residents who plant.It is suggested to mothers of toddlers to use an alternative to giving guava leaves as a treatment or prevention of acute diarrhea in toddlers.

Randomized, Placebo-Controlled, Double-Blind and Open-Label Studies in the Treatment and Prevention of Acute Diarrhea With Enterococcus faecium SF68.

Enterococcus faecium SF68® (SF68) is a licensed pharmaceutical for treatment and prevention of diarrhea in Austria, Italy and Switzerland. However, as for other probiotics, evidence for its efficacy is based on small to medium-sized studies. Four unpublished studies on the treatment of acute diarrhea and the prevention of antibiotic-associated diarrhea were analyzed: one randomized, double blind, placebo-controlled trial (RCT) for treatment (n = 1,143), one open-label study for treatment (n = 5,093), one RCT for prevention (n = 1,397) and one open-label study for prevention (n = 4,340). Patients in the treatment-arm and the open-label studies received SF68 (b.i.d. for the prevention studies, t.i.d. for the treatment trials) for 7 days. Primary end points were time to resolution of diarrhea (treatment) and percentage of development of diarrhea (prevention). The primary endpoint of the treatment study was met with a decreased time to resolution of diarrhea in SF68-treated patients compared to controls (median 3 vs. 4 days, p < 0.001). Time to resolution of secondary symptoms was also significantly reduced. Preventive treatment with SF68 was more effective than placebo with development of diarrhea in 8.6 vs. 16.2% (p < 0.001). Results from the open-label studies were consistent with the RCTs. The incidence of adverse events were low (1.1 and 1.4% in the RCT and 4.7 and 7.4% in the open-label studies). SF68 is effective and safe in the treatment of acute diarrhea and prevention of antibiotic-associated diarrhea.

Caregivers’ Knowledge of Environmental Sanitation and Hygiene Practices in the Prevention of Acute Diarrhoea among Under-Five Children in Calabar-South, Cross River State, Nigeria

Caregivers’ Knowledge of Environmental Sanitation and Hygiene Practices in the Prevention of Acute Diarrhoea among Under-Five Children in Calabar-South, Cross River State, Nigeria

Epidemiology Of Diarrheal Diseases in Children Below 5 Years in Wassit Province

Diarrheal diseases are major causes of morbidity and mortality among children in developing countries. We have analyzed distribution of diarrhea in children under five years of age who resided in rural or urban environments but attended Al_Karama hospital in Al_Kut city in Wassit. In this study we have found that diarrheal disease is more common in family that their parents illiterate, there is a peak incidence at1-2 years old. The disease more in infant who use bottle feeding than in those who feed on breast of their mothers and those with mixed type of feeding.The incidence of the disease is greater in children whose mothers use tap water for feeding. As for the Residence of the parents of these children, the occurrence of the condition is nearly equal between urban and rural regions.There is no significant difference between male and female.Conclusion: During this study, important environmental risk factors were recognized. Endangered groups and mothers with children under 5 years old should be aware of these risk factors in order to prevent their children's diseases. Prevention of acute diarrhea in children can reduce massive detriments to health system.

Aetiological characteristics of adult acute diarrhoea in a general hospital of Shanghai.

Epidemic surveillance is an effective means to determine the characteristics of acute diarrhoea and the benefits of disease control and prevention. The epidemiological, clinical, and aetiological data of adult (aged ⩾15 years) acute diarrhoea in a general hospital in Shanghai were collected and analysed. Out of 2430 acute diarrhoea patients, 162 subjects were sampled (sample ratio 15:1). The sampled subjects had an average age (±s.d.) of 44 ± 18 years; 142 (87·7%) had a history that indicated ingestion of contaminated food; and 40 (24·7%), 54 (33·3%), and 73 (45·1%) patients had diarrhoea that was attributed to viral, bacterial, and unknown aetiological origins respectively. Viral diarrhoea is mainly prevalent during the winter and spring months, while bacterial and diarrhoea of unknown aetiology occur mainly in the summer months. The average age of the unknown aetiology group (48 ± 19 years) was significantly older than that of the viral diarrhoea group (39 ± 16 years). The number of patients with vomiting in the viral group (30·6%) was significantly higher than that in the bacterial (17·1%) and unknown aetiology (8·2%) groups. Viral and bacterial infections are the main cause of acute diarrhoea in Shanghai. However, further effective technological means are needed to improve the surveillance, control, and prevention of acute diarrhoea.

N08C9 (Alliance): A Phase 3 Randomized Study of Sulfasalazine Versus Placebo in the Prevention of Acute Diarrhea in Patients Receiving Pelvic Radiation Therapy

To provide confirmatory evidence on the use of sulfasalazine to reduce enteritis during pelvic radiation therapy (RT), following 2 prior single-institution trials suggestive that benefit existed. A multi-institution, randomized, double-blind, placebo-controlled phase 3 trial was designed to assess the efficacy of sulfasalazine versus placebo in the treatment of RT-related enteritis during RT including the posterior pelvis (45.0-53.5Gy) and conducted through a multicenter national cooperative research alliance.Patients received 1000mg of sulfasalazine or placebo orally twice daily during and for 4weeks after RT. The primary endpoint was maximum severity of diarrhea (Common Terminology Criteria for Adverse Events version 4.0). Toxicity and bowel function were assessed by providers through a self-administered bowel function questionnaire taken weekly during RT and for 6weeks afterward. Eighty-seven patients were enrolled in the trial between April 29, 2011, and May 13, 2013, with evenly distributed baseline factors. At the time of a planned interim toxicity analysis, more patients with grade ≥3 diarrhea received sulfasalazine than received placebo (29% vs 11%, P=.04). A futility analysis showed that trial continuation would be unlikely to yield a positive result, and a research board recommended halting study treatment. Final analysis of the primary endpoint showed no significant difference in maximum diarrhea severity between the sulfasalazine and placebo arms (P=.41). Sulfasalazine does not reduce enteritis during pelvic RT and may be associated with a higher risk of adverse events than placebo. This trial illustrates the importance of confirmatory phase 3 trials in the evaluation of symptom-control agents.

Surveillance of enteric pathogens in outpatient children with acute diarrhea

Objective To monitor the clinical epidemiology and etiology of acute diarrhea in children in the outpatient setting in Shanghai. Methods An active surveillance study in Children's Hospital of Fudan University between August 2013 and July 2014 was conducted. Outpatient children with acute diarrhea were enrolled in this study and stool samples were collected. Pathogens including norovirus, diarrheagenic Escherichia coli (DEC), nontyphoidal Salmonella spp. (NTS), Campylobacter, Shigella, pathogenic vibrio and Yersinia enterocolitica were identified and typed. The χ2 test was used for statistical analysis. Results Of the 881 stool samples from enrolled children, the pathogens included into the target detection were identified in 246 (27.92%) cases. Norovirus, DEC, NTS, Campylobacter and Shigella were detected in 98 (11.12%) cases, 74 (8.40%) cases, 61 (6.92%) cases, 34 (3.86%) cases and 2 (0.23%) cases, respectively. Neither pathogenic vibrio nor Yersinia enterocolitica was identified. Children younger than 36 months old (3.27%, 26/794) had a lower risk (χ2=7.41, P=0.006) of Campylobacter infection compared with older children (9.20%, 8/87). Vomiting (37.76%) and watery diarrhea (21.34%) were more commonly seen in children with norovirus infection; fever and mucous stool were commonly seen in diarrheal children with NTS infection (40.98% and 21.31%, respectively) and Campylobacter infection (29.41% and 26.47%, respectively). Conclusion Enteric pathogens play a major role in childhood acute diarrhea in Shanghai. Continuous monitoring of enteric pathogens will be helpful for reasonable treatment and prevention of acute diarrhea in children. Key words: Acute diarrhea; Child; Enteric pathogens

N08C9 (Alliance) - A Phase 3 Randomized Study of Sulfasalazine Versus Placebo in the Prevention of Acute Diarrhea in Patients Receiving Pelvic Radiation Therapy

N08C9 (Alliance) - A Phase 3 Randomized Study of Sulfasalazine Versus Placebo in the Prevention of Acute Diarrhea in Patients Receiving Pelvic Radiation Therapy

Travelers' Preferences for the Treatment and Prevention of Acute Diarrhea

Travelers' Preferences for the Treatment and Prevention of Acute Diarrhea

Travelers’ Preferences for the Treatment and Prevention of Acute Diarrhea

A survey was designed to assess travelers' willingness to take antibiotic chemoprophylaxis against travelers' diarrhea (TD) or to intervene with antibiotic or symptomatic treatments. A brief written questionnaire was administered to clients in North American (United States and Canadian) and European (UK and German) travel clinic waiting rooms to assess length, purpose, and destination of their upcoming trips; their perceived risk of developing TD at their destination; and their preferences for hypothetical treatment or chemoprophylaxis options, which included descriptions, but no mention of brand names, of a systemically absorbed antibiotic based on a fluoroquinolone, a nonabsorbed antibiotic based on rifaximin, and an over-the-counter antidiarrheal similar to loperamide. The 209 UK and German travelers planned significantly longer travel than the 277 US and Canadian travelers (25 vs 15 d, p < 0.001) and correctly recognized high risk of TD more often than the North Americans (81% vs 61%, p < 0.001). More of the North Americans preferred any therapy options compared with the Europeans; only 14% of the North Americans preferred no treatment compared with 29% of the Europeans (p < 0.001). More of the North Americans and the Europeans preferred the nonabsorbed antibiotic than the systemically absorbed antibiotic, regardless of if combined with the antidiarrheal agent. Significantly more of the Europeans preferred not to take antibiotic chemoprophylaxis than North Americans (66% vs 37%, p < 0.001). Among the North Americans, significantly more travelers preferred chemoprophylaxis with the nonabsorbed than the systemic antibiotic (45% vs 33%, p= 0.003). Among the relatively small groups of travelers studied, the UK and German travelers were more cognizant of TD risk than US and Canadian travelers. The Europeans were less inclined to take chemoprophylaxis or treatment. Both groups preferred treatment or prophylaxis with the nonabsorbed antibiotic over the systemically absorbed antibiotic or the antidiarrheal agent.

Phase III, Double-Blind Study of Depot Octreotide Versus Placebo in the Prevention of Acute Diarrhea in Patients Receiving Pelvic Radiation Therapy: Results of North Central Cancer Treatment Group N00CA

To assess the effectiveness of depot octreotide for the prevention of diarrhea during pelvic radiation therapy. Patients receiving pelvic radiation therapy (planned minimum dose, 45 Gy; 1.7 to 2.1 Gy daily) were eligible for the study. From May 10, 2002, through October 14, 2005, 125 patients were randomly allocated in a double-blind fashion to receive octreotide (100 microg, administered subcutaneously on day 1, followed by depot octreotide, 20 mg, administered intramuscularly on days 2 and 29; n = 62) or to receive a placebo (n = 63). Grade 0, 1, 2, and 3 diarrhea were observed in 18%, 31%, 31%, and 21% of patients in the octreotide arm, respectively, and in 25%, 32%, 22%, and 21% of patients in the placebo arm, respectively (P = .64). Grade 0, 1, 2, and 3 abdominal cramps were observed in 32%, 45%, 21%, and 2% of patients receiving octreotide, respectively, and in 51%, 24%, 21%, and 5% of patients receiving the placebo, respectively (P = .053). Some patient-reported symptoms were worse in the octreotide group, including nocturnal bowel movements (70% v 45%; P = .004), clustering of bowel movements (90% v 69%; P = .004), and bleeding with bowel movements (57% v 35%; P = .01). As administered in this study, octreotide did not decrease diarrhea during pelvic radiation therapy. Some gastrointestinal symptoms were worse in patients treated with octreotide. Octreotide is not indicated for prevention of diarrhea during pelvic radiation therapy.

Case-Control Study of acute diarrhea in Children.

To determine the risk factor for acute diarrhea disease in children. In the survey, 220 cases and 220 controls were involved. Cases were children with loose watery feces, pathologically diagnosed as acute diarrhea by the physician, and enrolled from the Emergency Ward as the Incident Cases in Dr. Sheykh Hospital, Mashhad, northeast of Iran. Control group too, was enrolled from the same cases and the members were children whose risk factors disease were not the risk factor for acute diarrhea, and were enrolled from emergency ward of burn patients, accidents, acute respiratory diseases and eligible patients. By using univariate logistic regression models, variables consisting used milk up to 6 months age, antibiotic usage during the last 15 days, mother's employment, mother's acquaintance with ORS, occupancy, and water slack during the week before illness, were significantly related with acute diarrhea. In a multiple logistic regression, the relationship between the said factors as the independent variables and acute diarrhea was studied. Use of formulas before 6 month age with (95% CI 1.77- 5.79) OR=3.21, and tenantry with (95% CI 1.24-2.71) OR=1.83, and mother's employment with (95%CI 1.2-5.06) OR= 2.48 were factors affecting acute diarrhea which remained in the multiple logistic model and had significant relationship with the disease. During this study, important environmental risk factors were recognized. Endangered groups and mothers with children under 5 years old should be aware of these risk factors in order to prevent their children's diseases. Prevention of acute diarrhea in children can reduce massive detriments to health system.

Clinical Indications for Probiotics: An Overview

Probiotic bacteria are used to treat or prevent a broad range of human diseases, conditions, and syndromes. In addition, there are areas of medical use that have been proposed for future probiotic applications. Randomized double-blind studies have provided evidence of probiotic effectiveness for the treatment and prevention of acute diarrhea and antibiotic-induced diarrhea, as well as for the prevention of cow milk-induced food allergy in infants and young children. Research studies have also provided evidence of effectiveness for the prevention of traveler's diarrhea, relapsing Clostridium difficile-induced colitis, and urinary tract infections. There are also studies indicating that probiotics may be useful for prevention of respiratory infections in children, dental caries, irritable bowel syndrome, and inflammatory bowel disease. Areas of future interest for the application of probiotics include colon and bladder cancers, diabetes, and rheumatoid arthritis. The probiotics with the greatest number of proven benefits are Lactobacillus rhamnosus strain GG and Saccharomyces boulardii.

The role of probiotics and prebiotics in pediatric practice

To review the effects of probiotics and prebiotics in clinical pediatric practice. MEDLINE was searched, especially for articles that addressed their practical application, in the form of reviews, clinical trials and meta-analyses. Articles that had already been analyzed by the authors were also included. Scientific literature on probiotics and prebiotics has remarkably increased in the last 10 years. Their mechanisms of action have been experimentally investigated. Studies indicate that probiotics can act by competing with pathogens, modifying the intestinal environment by reduction in pH, as a result of fermentation products, interacting and modulating local and systemic inflammatory and immune response, among others. Clinical trials and meta-analyses show that probiotics seem to contribute towards the prevention of acute diarrhea and of antibiotic-associated diarrhea, in addition to shortening the duration of acute diarrhea. However, the data are inconsistent and there are no studies confirming their efficacy in terms of cost-benefit ratio. Preliminary studies show that probiotics in early life can reduce the occurrence of atopic dermatitis. The addition of prebiotics to infant formulas is associated with the change in the profile of the intestinal microbiota compared to infants fed milk formulas without prebiotics. Evidence indicates that new studies should be carried out about probiotics, prebiotics and symbiotics. The specific clinical effects that each probiotic or prebiotic may cause must be considered.

O papel dos probióticos e prebióticos na prática pediátrica

OBJETIVO: Revisar os efeitos dos probioticos e prebioticos em situacoes clinicas da pratica pediatrica. FONTES DOS DADOS: MEDLINE, preferencialmente os artigos que abordavam aspectos de aplicabilidade pratica, na forma de revisoes, ensaios clinicos e meta-analises. Artigos que ja eram do conhecimento dos autores tambem foram utilizados. SINTESE DOS DADOS: A literatura cientifica sobre probioticos e prebioticos apresentou crescimento expressivo nos ultimos 10 anos. Seus mecanismos de acao vem sendo investigados experimentalmente. Os estudos indicam que os probioticos podem exercer seus efeitos competindo com patogenos, modificando o ambiente intestinal pela reducao do pH, em consequencia dos produtos da fermentacao, interagindo e modulando a resposta inflamatoria e imunologica local e sistemica, entre outros. Ensaios clinicos e meta-analises mostram que os probioticos parecem contribuir para a prevencao da diarreia aguda e da diarreia associada ao uso de antibioticos, alem de encurtar a duracao da diarreia aguda. No entanto, existem dados contraditorios, alem de nao existirem ainda estudos confirmando sua efetividade do ponto de vista da relacao custo-beneficio. Estudos preliminares mostram que probioticos no inicio da vida podem reduzir a ocorrencia de dermatite atopica. A adicao de prebioticos em formulas para lactentes associa-se com mudanca do perfil da microbiota intestinal em relacao aos lactentes que recebem formula lactea sem prebioticos. CONCLUSOES: As evidencias indicam que novos estudos devem ser realizados sobre probioticos, prebioticos e simbioticos. Um aspecto que deve ser reforcado e a especificidade dos efeitos que cada probiotico ou prebiotico pode apresentar do ponto de vista clinico.

Phase III double-blind study of depot octreotide versus placebo in the prevention of acute diarrhea during pelvic radiation therapy: Results of North Central Cancer Treatment Group protocol N00CA

8506 Background: A randomized study (Int J Rad Oncol Biol Phys 54:195–202, 2002) demonstrated a beneficial effect for octreotide in the treatment of diarrhea in patients receiving pelvic radiation therapy. This North Central Cancer Treatment Group study was undertaken to determine the effectiveness of depot octreotide in the prevention of diarrhea during pelvic radiation therapy. Methods: Patients receiving pelvic radiation therapy, with a planned minimum dose of 45 Gy at 1.70–2.1 Gy per day, were eligible for this study. The study was designed for a Wilcoxon test, with 112 evaluable patients, to have 85% power to detect a further one grade decrease in diarrhea over and above that experienced by patients treated with placebo. Between June 13, 2002 and October 28, 2005, 120 evaluable patients were randomly allocated, in double blind fashion, to receive octreotide (62 patients) or placebo (58 patients), prior to the fourth radiation therapy fraction. Octreotide dosing: Octreotide, 100 micrograms subcutaneously on day 1 followed by depot octreotide, 20 milligrams intramuscularly on days 2 and 29. Results: Grade 0, 1, 2 and 3 diarrhea was observed in 17%, 32%, 26% and 26% of patients treated with octreotide and 18%, 34%, 22%, and 26% of patients treated with placebo (P=0.86). Grade 0, 1, 2 and 3 tenesmus was observed in 55%, 30%, 11% and 4% of patients treated with octreotide and 76%, 16%, 4%, and 4% of patients treated with placebo (P=0.04). No other statistically significant differences in toxicity were observed. Conclusions: Octreotide, as administered in this study, did not decrease diarrhea during pelvic radiation therapy. [Table: see text]

Acidified Milk Formula Supplemented With Bifidobacterium lactis: Impact on Infant Diarrhea in Residential Care Settings

ABSTRACTObjectivesProbiotics may be useful in preventing acute infectious diarrhea. Bifidobacteria are particularly attractive as probiotics agent because they constitute the predominant colonic flora of breastfed infants and are thought to play a role in the decreased incidence of diarrhea in breastfed infants.MethodsThis was a multicenter, double‐blind, controlled study to evaluate the efficacy of a milk formula supplemented with viable Bifidobacterium lactis strain Bb 12 (BbF) in the prevention of acute diarrhea in infants younger than 8 months living in residential nurseries or foster care centers.ResultsNinety healthy children received either the BbF or a conventional formula (CF) daily. The mean duration of the stay in the residential center was similar (137 v 148 days). At enrollment, there were no differences between the two groups with respect to age (3.7 ± 2.1 months), gender, anthropometric data, history of allergy or gastrointestinal disease, frequency of breast‐feeding in the neonatal period or timing of introduction of solid food. Altogether, 28.3% of the BbF infants had diarrhea during the study compared with 38.7% of controls (NS). There was a statistically insignificant trend for shorter episodes of diarrhea in the BbF group (5.1 ± 3.3 days v 7 ± 5.5 days, NS). The number of days with diarrhea was 1.15 ± 2.5 in the BbF group with a daily probability of diarrhea of 0.84 versus 2.3 ± 4.5 days and 1.55, respectively, in the CF group (P = 0.0002 and 0.0014). Feeding infants with the BbF reduced their risk of getting diarrhea by a factor of 1.9 (range, 1.33–2.6). Analysis of the cumulative incidence of diarrheal episodes showed a trend that the first onset of diarrhea occurred later in the BbF group.ConclusionThese results provide some evidence that viable Bifidobacterium lactis strain Bb 12, added to an acidified infant formula, has some protective effect against acute diarrhea in healthy children.

Setting Priorities on the Prevention of Acute Diarrhoea.

Setting Priorities on the Prevention of Acute Diarrhoea.

Book Reviews

Book reviewed in this article:A Colour Atlas of Brain Disorders in the Newborn By L. S. De Vries, L. M. S. Dubowitz, V. Dubowitz and J. M. PennockTutorials in Paediatric Differential Diagnosis Edited by D. J. Field, D. Isaacs and J. StroobantThe Treatment and Prevention of Acute Diarrhoea: Practical Guidelines, 2nd Edn.Weaning: from Breast Milk to Family Food. A Guide for Health and Community WorkersDietary Management of Young Children with Acute Diarrhoea: Practical Manual for District Programme Managers By D. B. Jelliffe and E. F. P. JelliffeDry All Night By Alison Mack