Community-based controlled trial of dietary management of children with persistent diarrhea: sustained beneficial effect on ponderal and linear growth.
BACKGROUND
Uncontrolled hospital-based studies in developing countries have reported promising results of dietary rehabilitation of children with persistent diarrhea.


OBJECTIVE
The objective was to determine the immediate and long-term effects of a dietary supplement and micronutrients given to children with persistent diarrhea during the episode and for 1 wk during convalescence.


METHODS
The study was open, controlled, and community-based and was conducted in a periurban area in Guinea-BISSAU: Children <3 y of age with persistent diarrhea were identified during weekly household visits. The children randomly assigned to the treatment and control groups were examined by a physician and all medical conditions were treated. The children in the treatment group were offered home-based dietary treatment consisting of locally available foods and micronutrient supplements.


RESULTS
There were 141 episodes of persistent diarrhea during the study: 70 in the treatment group (in 58 children) and 71 in the control group (in 62 children). During the intervention period (median: 17 d), weight gain in the treatment group exceeded that of the control group by 61.5 g/wk (95% CI: 49.2, 73.8), whereas there was no significant difference in linear growth on the basis of knee-heel length. At a median follow-up period of 6.6 mo after the intervention was stopped, weight gain in the treatment group exceeded that of the control group by 12.5 g/wk (95% CI: 7.7, 17.3); knee-heel length was 7.5 mm/y (4.8, 10.2) greater and total length was 0.65 cm/y (0.11, 1.19) greater in the treatment group.


CONCLUSIONS
Therapeutic feeding and micronutrient supplementation had an immediate and sustained beneficial effect on growth in children with persistent diarrhea.
Valentiner-Branth
P
P
Projecto de Saúde de Bandim, Bissau, Guinea-Bissau. pvb@ssi.dk
Steinsland
H
H
Santos
G
G
Perch
M
M
Begtrup
K
K
Bhan
M K
MK
Dias
F
F
Aaby
P
P
Sommerfelt
H
H
Mølbak
K
K
D000284:Administration, Oral; D001827:Body Height; D001835:Body Weight; D002675:Child, Preschool; D003967:Diarrhea / Q000178:diet therapy* / Q000503:physiopathology; D005243:Feces / Q000382:microbiology / Q000469:parasitology; D005260:Female; D006128:Growth / Q000502:physiology*; D006169:Guinea-Bissau; D006801:Humans; D007223:Infant; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D012016:Reference Values; D013997:Time Factors; D014505:Urban Population; D014815:Vitamins / Q000008:administration & dosage*
D018977:Micronutrients; D014815:Vitamins