Pacheco I

Effect of an Acidified Milk on Diarrhoea and the Carrier State in Infants of Low Socio‐Economic Stratum

ABSTRACT. The effect on diarrhoeal disease of an acidified, modified powdered cows milk infant formula (Pelargon®) was evaluated in 82 infants (Group I) for six months; 104 infants who received the same formula but non acidified, served as controls (Group II). Nutritional status remained satisfactory in both groups throughout the observation period. Some children rejected the taste of the acidified milk. The incidence of diarrhoea was lower in Group I (p<0.001). The proportion of days in which the children suffered from acute diarrhoea, and the duration of the episodes were also lower in the children given the acidified milk (p<0.001). The rate of detection of enteropathogens and the species identified were comparable in both groups. Carrier rates for bacterial enteropathogens fell over time in Group I while they rose in Group II (p<0.001). Carrier rates for enteric parasites were comparable to those expected in our setting for this age group. These results suggest that acidified milk exerts a protective effect against diarrhoeal disease.

Faecal excretion of rotavirus and other enteropathogens in newborns of the high and low socio-economic stratum in Santiago, Chile

Faecal excretion of enteropathogens was studied in newborns in their first week of life. Rotavirus was investigated in 225 neonates, of whom 107 belonged to the low socio-economic stratum (SES) and 118 to the high SES. Half of each group were delivered by caesarean section. Rotavirus was detected in 10 infants (4.4%). Eight of them had been in the same ward and excreted the same viral electrophoretype. Enteropathogenic bacteria were isolated from 8 out of 57 (14.0%) newborns. Positive cultures were equally distributed by SES and route of delivery. Giardia lamblia was the only parasite detected, in one infant (2.6%) of the high SES. None of the children developed symptoms. Faecal excretion of enteropathogens ended spontaneously within a week in all cases. It is suggested that the lack of symptomatology and the spontaneous termination of the faecal excretion are related to immaturity of the small intestinal mucosa, that does not allow the completion of the steps that must take place during a successful infectious event.

Rice-based formulas for rapid refeeding of infants with acute diarrhoea. A field trial

Two infant formulas based on a high protein rice flour (HPRF) and a control soy formula were studied in the early feeding of 56 infants, 3 to 6 months of age, with acute diarrhoea1 disease (n = 20, 17 and 19, respectively). A double blind, randomised study design was used. An oral glucose electrolyte solution was offered on days 1-2 along with formula; full formula feedings were reached by day 3 and continued to day 60. HPRF formulas were well accepted and tolerated. Differences in clinical course and weight gain among the experimental and control groups were not significant. Mean duration of liquid stools was 3.5 and 3.8 days for HPRF-fed infants and 3.3 days for those on the soy protein formula; faeces were well formed by days 8.2, 9.9 and 7.7, respectively (not statistically different). Infants maintained normal weight and height gain to day 60. Formulas based on HPRF are acceptable in the nutritional management of acute infantile diarrhoea.

ABNORMAL COLONIZATION OF THE SMALL INTESTINE IN SCHOOL AGE CHILDREN OF THE LOW (L) AND HIGH (H) SCCIOECONOMIC LEVEL.

Environmental enteropathy and asymptomatic excretion of enteropathogens have been demonstrated in apparently healthy subjects. L and H socioeconomic level are associated with different degrees of environmental contamination. The expired H2 excretion (EHE) was studied in fasted school age children 4 to 14 years old, aiming to quantitate the abnormal colonization of the small intestine by means of a noninvasive technique. Samples of EHE were obtained during fasting and every 15 minutes during 240 minutes after the ingestion of 150mg/kg of lactulose. H2 was measured in a Quintron Microlyzer 12i chromatograph. In 39/156 (25.0%) of the L group children and in 55/155 (35.5%)of the H group children (55,7% males and 19,8% females) excreted more than 10 ppm of EHE during fasting. EHE increased more than 20 ppm during the first 90 minutes in 11/156 (7,1%) of L and 27/155 (17,4%) of H children (p<.005). No differences related to age were found. The colonic peak was detected at 150 minutes.Conclusions: Results suggest that both L and H school age children present microbiological contamination of the small bowel since early ages. The higher excretion of H2 in H group could be explained by different fiber contents of diet ingested during the days prior to the test.FONDECY 91-1043