Use of probiotics in the management of acute watery diarrhoea in Nigerian children: How effective are S. boulardii only preparations?

Abstract

Background: Diarrhoeal diseases are a major cause of death worldwide, particularly among under-fives and probiotics are used in the management of diarrheal diseases. While some probiotics are of unproven usefulness, others are. Despite the burden of diarrhoea diseases in Africa; there is a paucity of studies to support the efficacy or otherwise of S. boulardii among children with diarrheal disease. This study examined the impact of S. boulardii on the clinical course of acute watery diarrhoea in children in a tertiary hospital in Nigeria.

Methods: Two hundred and fifty under-five children with acute watery diarrhoea were recruited and treated in the hospital. One hundred and twenty-five were given probiotics (S. boulardii) in addition to Oral Rehydration solution (ORS), zinc and antibiotics while the other one hundred and twenty-five were not on probiotics (Controls). Their stool frequency on the 3^rd and 5^th days and the duration of diarrhoea were used to assess the outcome. Information was obtained using a questionnaire and then analysed.

Result: The majority of the children (58.8%) were in their second half of infancy (7-12 months). The average number of diarrheal episodes was significantly lower among the subjects by the 3^rd day of intervention (t = 2.496, p = 0.013) but not by the 5^th day (t = 0.212; p = 0.832). Duration of diarrhoea, however, was not significantly different between the subjects and controls (p = 0.246).

Conclusion: S. Boulardiionly probiotic preparations reduce the number of diarrhoeal episodes but not the duration of diarrhoea among under- 5s.