Green banana-supplemented diet in the home management of acute and prolonged diarrhoea in children: a community-based trial in rural Bangladesh.
OBJECTIVE
To determine the effectiveness of green banana in the home management of acute (<7 days) or prolonged (≥ 7 days) diarrhoea at the community level.


METHODS
A cluster randomized field trial was conducted among 2968 Bangladeshi rural children 6-36 months old. Wards (villages) were randomly assigned to either a standard care group or a standard care plus green banana group where mothers were instructed to add cooked green banana to the diets of diarrhoeal children. Through a village-based surveillance system, diarrhoeal morbidity data (severity, duration, compliance) were collected for 14 days. Treatment effects were determined by analysing cumulative probability of cure by testing Cox proportional hazards models and relative risk (RR).


RESULTS
The cumulative probability of cure was significantly (P < 0.001) different in children receiving GB for both acute [hazard ratio (HR) = 0.63 (95% CI: 0.56-0.67)] and prolonged diarrhoea [HR = 0.38 (95% CI: 0.26-0.59)]. The recovery rates of children with acute diarrhoea receiving GB (vs. control) were significantly more by day 3: 79.9%vs. 53.3% [(RR) = 0.47, 95% CI: 0.41-0.55], (P < 0.001) and day 7: 96.6%vs. 89.1% (RR = 0.32; 0.22-0.46), (P < 0.001). Children with prolonged diarrhoea receiving green banana had significantly higher recovery rates by day 10: 79.8%vs. 51.9% (RR = 0.42; 0.23-0.73), (P < 0.001) and day 14: 93.6%vs. 67.2% (RR = 0.22; 0.08-0.54), (P < 0.001).


CONCLUSIONS
A green banana-supplemented diet hastened recovery of acute and prolonged childhood diarrhoea managed at home in rural Bangladesh.
Rabbani
G H
GH
Clinical Sciences Division, ICDDR,B, Dhaka, Bangladesh. rabbani@icddrb.org
Larson
C P
CP
Islam
R
R
Saha
U R
UR
Kabir
A
A
D000208:Acute Disease; D000930:Antidiarrheals / Q000008:administration & dosage*; D001459:Bangladesh; D002675:Child, Preschool; D003153:Community Health Services; D003967:Diarrhea / Q000178:diet therapy*; D003968:Diarrhea, Infantile / Q000178:diet therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D028521:Musa; D008517:Phytotherapy / Q000379:methods*; D028321:Plant Preparations / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D012424:Rural Population; D012720:Severity of Illness Index
D000930:Antidiarrheals; D028321:Plant Preparations