Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial.

Recent reviews suggest common infectious diseases continue to be a major cause of death among preschool children in developing countries. Identification of feasible strategies to combat this disease burden is an important public health need. We evaluated the efficacy of adding prebiotic oligosacchar...

Full description

Bibliographic Details
Main Authors: Sunil Sazawal, Usha Dhingra, Girish Hiremath, Archana Sarkar, Pratibha Dhingra, Arup Dutta, Priti Verma, Venugopal P Menon, Robert E Black
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2010-08-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC2921405?pdf=render
_version_ 1818503759661105152
author Sunil Sazawal
Usha Dhingra
Girish Hiremath
Archana Sarkar
Pratibha Dhingra
Arup Dutta
Priti Verma
Venugopal P Menon
Robert E Black
author_facet Sunil Sazawal
Usha Dhingra
Girish Hiremath
Archana Sarkar
Pratibha Dhingra
Arup Dutta
Priti Verma
Venugopal P Menon
Robert E Black
author_sort Sunil Sazawal
collection DOAJ
description Recent reviews suggest common infectious diseases continue to be a major cause of death among preschool children in developing countries. Identification of feasible strategies to combat this disease burden is an important public health need. We evaluated the efficacy of adding prebiotic oligosaccharide and probiotic Bifidobacterium lactis HN019 to milk, in preventing diarrhea, respiratory infections and severe illnesses, in children aged 1-4 years as part of a four group study design, running two studies simultaneously.In a community based double-masked, randomized controlled trial, children 1-3 years of age, willing to participate, were randomly allocated to receive either control milk (Co; n = 312) or the same milk fortified with 2.4 g/day of prebiotic oligosaccharide and 1.9x10(7) colony forming unit (c.f.u)/day of probiotic Bifidobacterium lactis HN019 (PP; n = 312). Children were followed up for 1 year providing data for 1-4 years. Biweekly household surveillance was conducted to gather information on compliance and morbidity. Both study groups were comparable at baseline; compliance to intervention was similar. Overall, there was no effect of prebiotic and probiotic on diarrhea (6% reduction, 95% Confidence Interval [CI]: -1 to 12%; p = 0.08). Incidence of dysentery episodes was reduced by 21% (95% CI: 0 to 38%; p = 0.05). Incidence of pneumonia was reduced by 24% (95% CI: 0 to 42%; p = 0.05) and severe acute lower respiratory infection (ALRI) by 35% (95% CI: 0 to 58%; p = 0.05). Compared to children in Co group, children in PP group had 16% (95% CI: 5 to 26%, p = 0.004) and 5% (95% CI: 0 to 10%; p = 0.05) reduction in days with severe illness and high fever respectively.Milk can be a good medium for delivery of prebiotic and probiotic and resulted in significant reduction of dysentery, respiratory morbidity and febrile illness. Overall, impact of diarrhea was not significant. These findings need confirmation in other settings.
first_indexed 2024-12-10T21:28:14Z
format Article
id doaj.art-5fee62354c544527b1710d523a218923
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-10T21:28:14Z
publishDate 2010-08-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-5fee62354c544527b1710d523a2189232022-12-22T01:32:55ZengPublic Library of Science (PLoS)PLoS ONE1932-62032010-08-0158e1216410.1371/journal.pone.0012164Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial.Sunil SazawalUsha DhingraGirish HiremathArchana SarkarPratibha DhingraArup DuttaPriti VermaVenugopal P MenonRobert E BlackRecent reviews suggest common infectious diseases continue to be a major cause of death among preschool children in developing countries. Identification of feasible strategies to combat this disease burden is an important public health need. We evaluated the efficacy of adding prebiotic oligosaccharide and probiotic Bifidobacterium lactis HN019 to milk, in preventing diarrhea, respiratory infections and severe illnesses, in children aged 1-4 years as part of a four group study design, running two studies simultaneously.In a community based double-masked, randomized controlled trial, children 1-3 years of age, willing to participate, were randomly allocated to receive either control milk (Co; n = 312) or the same milk fortified with 2.4 g/day of prebiotic oligosaccharide and 1.9x10(7) colony forming unit (c.f.u)/day of probiotic Bifidobacterium lactis HN019 (PP; n = 312). Children were followed up for 1 year providing data for 1-4 years. Biweekly household surveillance was conducted to gather information on compliance and morbidity. Both study groups were comparable at baseline; compliance to intervention was similar. Overall, there was no effect of prebiotic and probiotic on diarrhea (6% reduction, 95% Confidence Interval [CI]: -1 to 12%; p = 0.08). Incidence of dysentery episodes was reduced by 21% (95% CI: 0 to 38%; p = 0.05). Incidence of pneumonia was reduced by 24% (95% CI: 0 to 42%; p = 0.05) and severe acute lower respiratory infection (ALRI) by 35% (95% CI: 0 to 58%; p = 0.05). Compared to children in Co group, children in PP group had 16% (95% CI: 5 to 26%, p = 0.004) and 5% (95% CI: 0 to 10%; p = 0.05) reduction in days with severe illness and high fever respectively.Milk can be a good medium for delivery of prebiotic and probiotic and resulted in significant reduction of dysentery, respiratory morbidity and febrile illness. Overall, impact of diarrhea was not significant. These findings need confirmation in other settings.http://europepmc.org/articles/PMC2921405?pdf=render
spellingShingle Sunil Sazawal
Usha Dhingra
Girish Hiremath
Archana Sarkar
Pratibha Dhingra
Arup Dutta
Priti Verma
Venugopal P Menon
Robert E Black
Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial.
PLoS ONE
title Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial.
title_full Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial.
title_fullStr Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial.
title_full_unstemmed Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial.
title_short Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial.
title_sort prebiotic and probiotic fortified milk in prevention of morbidities among children community based randomized double blind controlled trial
url http://europepmc.org/articles/PMC2921405?pdf=render
work_keys_str_mv AT sunilsazawal prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial
AT ushadhingra prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial
AT girishhiremath prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial
AT archanasarkar prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial
AT pratibhadhingra prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial
AT arupdutta prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial
AT pritiverma prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial
AT venugopalpmenon prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial
AT roberteblack prebioticandprobioticfortifiedmilkinpreventionofmorbiditiesamongchildrencommunitybasedrandomizeddoubleblindcontrolledtrial