Pv. Branth et al., Community-based controlled trial of dietary management of children with persistent diarrhea: sustained beneficial effect on ponderal and linear growth, AM J CLIN N, 73(5), 2001, pp. 968-974
Background: Uncontrolled hospital-based studies in developing countries hav
e reported promising results of dietary rehabilitation of children with per
sistent diarrhea.
Objective: The objective was to determine the immediate and long-term effec
ts of a dietary supplement and micronutrients given to children with persis
tent diarrhea during the episode and for 1 wk during convalescence.
Design: The study was open, controlled, and community-based and was conduct
ed in a periurban area in Guinea-Bissau. Children <3 y of age with persiste
nt diarrhea were identified during weekly household visits. The children ra
ndomly assigned to the treatment and control groups were examined by a phys
ician and all medical conditions were treated. The children in the treatmen
t group were offered home-based dietary treatment consisting of locally ava
ilable foods and micronutrient supplements.
Results: There were 141 episodes of persistent diarrhea during the study: 7
0 in the treatment group (in 58 children) and 71 in the control group (in 6
2 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 a
fter the intervention was stopped, weight gain in the treatment group excee
ded that of the control group by 12.5 g/wk (95% CI: 7.7, 17.3); knee-heel l
ength 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.
Conclusion: Therapeutic feeding and micronutrient supplementation had an im
mediate and sustained beneficial effect on growth in children with persiste
nt diarrhea.