Skip to main content Accessibility help
×
Home

Effect of an energy-dense diet on the clinical course of acute shigellosis in undernourished children

  • Ramendra N. Mazumder, Hassan Ashraf (a1), Syed S. Hoque (a1), Iqbal Kabir (a1), Naseha Majid (a1), Mohammad A. Wahed (a1), George J. Fuchs (a1) and Dilip Mahalanabis (a1)...

Abstract

To date there have been few reports on the impact of dietary intervention on the clinical course of acute shigellosis. Current management of acute shigellosis is primarily focused on antibiotic therapy with less emphasis on nutritional management. In a randomised clinical trial, we examined the role of an energy-dense diet on the clinical outcome in malnourished children with acute dysentery due to shigellosis. Seventy-five children aged 12–48 months with acute dysentery randomly received either a milk–cereal formula with an energy density of 4960 kJ/l (test group) or a milk–cereal formula with energy of 2480 kJ/l (control group) for 10 d in hospital. In both milk–cereal formulas, protein provided 11 % energy. In addition, the standard hospital diet was offered to all children and all children received an appropriate antibiotic for 5 d. The mean food intakes (g/kg per d) in the test and control groups were: 112 (SE 2·28) AND 116 (se 3·48) (P=0·16) on day 1; 118 (se 2·72) and 107 (se 3·13) (P=0·04) on day 5; 120 (se 2·25) and 100 (se 3·83) (P=0·04) on day 10. The mean energy intakes (kJ/kg per d) in the test and control groups respectively were: 622 (se 13·2) and 315 (se 11·3) (P<0·05) on day 1; 655 (se 15·1) and 311 (se 7·98) (P<0·05) on day 5; 672 (se 14·7) and 294 (se 11·1) (P<0·05) on day 10. The food and energy intakes were mostly from the milk–cereal diet. There was no difference between two groups in resolution of fever, dysenteric (bloody and or mucoid) stools, stool frequency and tenesmus. However, vomiting was more frequently observed among the test-group children during the first 5 d of intervention (67 % v. 41 %, P=0·04). There was an increase in the mean weight-for-age (%) in the test group compared with the control group after the 10 d of dietary intervention (6·2 (se 0·6) v. 2·7 (se 0·4), P<0·01). In addition, resolution of rectal prolapse was better (26 % v. 8 %, P=0·04) in the test group v. control group after 5 d, and 13 % v. 6 %, (P=0·08) after 10 d of dietary intervention. Supplementation with a high-energy diet does not have any adverse effect on clinical course of acute shigellosis and reduces the incidence of rectal prolapse in malnourished children.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Effect of an energy-dense diet on the clinical course of acute shigellosis in undernourished children
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Effect of an energy-dense diet on the clinical course of acute shigellosis in undernourished children
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Effect of an energy-dense diet on the clinical course of acute shigellosis in undernourished children
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author:Dr Ramendra N. Mazumder, present address GI Laboratory,Western General Hospital, Edinburgh EH4 2XU, Scotland, fax +44 (0)131 537 1007, email rmazumder@ed.ac.uk

References

Hide All
Bennish, ML (1991) Potentially lethal complications of shigellosis. Review of Infectious Disease 13 (Suppl. 4), pp. S319S324.
Bennish, ML, Harris, JR, Wojtyniak, BJ and Struelens, M (1990) Death in shigellosis: incidence and risk factors in hospitalised patients. Journal of Infectious Disease 161, pp. 500506.
Black, RE, Brown, KH and Becker, S (1984) Effects of diarrhoea associated with specific enteropathogens on the growth of children in rural Bangladesh. Paediatrics 73, pp. 799805.
Black, RE, Merson, MH, Rahman, ASMM, Yunus, M, Alim, ARMA, Huq, MI, Yolken, RH and Curlin, GT (1980) A two-year study of bacterial, viral, and parasitic agents associated with diarrhoea in rural Bangladesh. Journal of Infectious Disease 142, pp. 660664.
Briend, A, Dykewicz, C, Graven, K, Mazumder, RN, Wojtyniak, B and Bennish, M (1986) Usefulness of nutritional indices and classification in predicting death of malnourished children. British Medical Journal 293, pp. 373375.
Hamil, PVV (1977) NCHS Growth Curve for Children birth–18 years, United States, DHEW publication no. (PHS) 78-165, Vital and Health Statistics, series 11, no.165. Hyattsville, MD: National Center for Health Statistics.
Henry, FJ, Alam, N, Aziz, KMS and Rahaman, MM (1987) Dysentery not watery diarrhoea is associated with stunting in Bangladeshi children. Human Nutrition: Clinical Nutrition 41C, pp. 243249.
International Centre for Diarrhoeal Disease Research, Bangladesh (1994) Annual Report. Dhaka: ICDDR, B.
Kabir, I, Malek, MA, Mazumder, RN and Mahalanabis, D (1993) Rapid catch-up growth of children fed a high protein-diet during convalescence from shigellosis. American Journal of Clinical Nutrition 57, pp. 441445.
Katz, SL (1986) The burden of disease resulting from diarrhoea. In New Vaccine Development: Establishing Priorities. Diseases of Importance in Developing Countries, pp. 165. [Katz, SL,editors]. Washington, DC: National Academy Press.
Mackle, EJ and Parks, TG (1986) The pathogenesis and pathophysiology of rectal prolapse and solitary rectal prolapse syndrome. Clinical Gastroenterology 15, pp. 9851002.
Martorell, R, Yarbrough, C, Lechtig, A, Habicht, JP and Klein, RE (1975) Diarrhoeal diseases and growth retardation in pre-school Guatemalan children. American Journal of Physiological Anthropology 43, pp. 341346.
Molla, AM, Molla, A, Sarker, SA, Rahaman, MM (1983) Food intake during and after recovery from diarrhoea in children. In Diarrhoea and Malnutrition: Interactions, Mechanisms and Interventions. pp. 155160. [Chen, LC and Scrimshaw, NS, editors]. New York, NY: Plenum Press.
Rowland, MGM, Cole, TJ and Whitehead, RG (1977) A quantitative study into the role of infection in determining nutritional status in Gambian village children. British Journal of Nutrition 37, pp. 441450.
Scrimshaw, NS (1977) Effect of infection on nutrient requirements. American Journal of Clinical Nutrition 30, pp. 15361544.
Struelens, MJ, Patte, D, Kabir, I, Salam, MA, Nath, SK and Butler, T (1985) Shigella septicaemia: prevalence, presentation, risk factors and outcome. Journal of Infectious Disease 152, pp. 784790.
Tomkins, A (1981) Nutritional status and severity of diarrhoea among pre-school children in rural Nigeria. Lancet 1, pp. 860862.
Victoria, CG, Huntly, SRA, Fuchs, SC and Barrows, FC (1993) International difference in clinical patterns of diarrhoeal deaths: a comparison of children from Brazil, Senegal, Bangladesh, and India. Journal of Diarrhoeal Disease Research 11, pp. 2529.
World Health Organization (1994) Programme for the Control of Diarrhoeal Diseases. The Management of Bloody Diarrhoea in Young Children. WHO/CDD/94.49. Geneva: WHO.

Keywords

Effect of an energy-dense diet on the clinical course of acute shigellosis in undernourished children

  • Ramendra N. Mazumder, Hassan Ashraf (a1), Syed S. Hoque (a1), Iqbal Kabir (a1), Naseha Majid (a1), Mohammad A. Wahed (a1), George J. Fuchs (a1) and Dilip Mahalanabis (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed