Effects of probiotics and synbiotics on diarrhea in undernourished children: Systematic review with meta-analysis.

Richard Mbusa Kambale, Fransisca Isia Nancy, Gaylord Amani Ngaboyeka, Joe Bwija Kasengi, Laure B Bindels, Dimitri Van der Linden

Journal: Clinical nutrition (Edinburgh, Scotland) 2021;40(5):3158-3169

PMID: 33446418

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Undernutrition predisposes children to a greater incidence and duration of diarrhea. No review and meta-analysis have yet been conducted to assess effectiveness of probiotics and synbiotics in undernourished children.

AIMS

To assess the effectiveness of probiotics and synbiotics on diarrhea in undernourished children.

METHODS

Randomized, double-blind, placebo-controlled trials evaluating the effects of probiotics and synbiotics on diarrhea in undernourished children were searched from 1990 to May 2020. Recommendations of the Cochrane Handbook and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement were followed.

RESULTS

The systematic review identified 15 trials with 6986 patients. The meta-analysis revealed that treatment with probiotic or synbiotic reduced significantly both the duration of diarrhea [Weighted mean difference (WMD) = -1.05 day, 95% CI (-1.98, -0.11)] and the hospital stay duration [Standard mean difference (SMD) = -2.87 days, 95% CI (-5.33, -0.42)], especially in specific patient subsets. In both groups, similar rates of vomiting and nutritional recovery were observed. No probiotics or synbiotics-related adverse effects were reported. Subgroup analyses showed that probiotic and synbiotic treatment were more effective in reducing risk of diarrhea in outpatients [Risk ratio (RR) = 0.86, 95%CI (0.75-0.98)].

CONCLUSION

This meta-analysis supports the potential beneficial roles of probiotics and synbiotics on diarrhea in undernourished children.

Address: Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium; Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo; General Pediatrics, Pediatric Department, Hôpital Provincial Général de Référence de Bukavu, Democratic Republic of Congo. Electronic address: [email protected].; Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo; General Pediatrics, Pediatric Department, Hôpital Provincial Général de Référence de Bukavu, Democratic Republic of Congo.; Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium; Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium.; Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium; Pediatric Infectious Diseases, General Pediatrics, Pediatric Department, Cliniques universitaires Saint Luc, Brussels, Belgium.

DOI: 10.1016/j.clnu.2020.12.026

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MeSH Terms: Child Nutrition Disorders, Child, Preschool, Diarrhea, Humans, Malnutrition, Probiotics, Synbiotics