Saccharomyces boulardii added to zinc in management of rotavirus gastroenteritis among children aged 3-36 months: A pilot study at Nsambya hospital

2024-10-21T16:11:39Z

Saccharomyces boulardii added to zinc in management of rotavirus gastroenteritis among children aged 3-36 months: A pilot study at Nsambya hospital Byaruhanga, Charles Background: Even with the current standard of care for acute water diarrhea, rotavirus infection still kills 527,000 children annually. Objectives: To determine the effect of adding Saccharomyces boulardii to zinc in the management of rotavirus gastroenteritis among children aged 3-36 months. Methods: A pilot randomized open label trial was conducted among hospitalized children with rotavirus gastroenteritis in the paediatrics ward. Ninety five patients were screened for rotavirus using SD BIOLINE Rotavirus kit; 42 children tested positive for rotavirus. These were randomly assigned into two equal groups to receive both zinc gluconate and rehydration (standard of care) or Saccharomyces boulardii added to standard of care group. The study participants had baseline characteristic recorded and then followed up daily for 5 days assessing diarrhoea and vomiting characteristics. Results: Patients consisted of 24 females and 20 males with mean age of 12.15 ±7.18 months. Baseline characteristics were similar; all children presented with diarrhoea and vomiting. No significant differences regarding duration of illness, episodes of diarrhoea and vomiting and degree of dehydration was found among the two groups at time of hospitalization. Adding Saccharomyces boulardii to standard of care had the following effect; reduced the mean duration of diarrhea from 4.47 days 2. 70 days when compared to Standard of care (P=0.001), reduced the time to resolution of vomiting but this was not statistically significant (p = 0.944). Conclusions: Adding Saccharomyces boulardii to zinc as compared to standard of care; reduced the duration of rotavirus diarrhoea but had little effect on time to resolution of vomiting. Recommendation: - A larger study is needed to assess possibility of adding Saccharomyces boulardii as an adjunct therapy to zinc formulation in the management of rotavirus diarrhoea in a similar setting. - Further, studies with a larger sample size are needed to study why the addition of Saccharomyces boulardii added to zinc gluconate increased the time to resolution of vomiting. Dr. Namisi P Charles; Dr. Mworozi Edson

Predictive value of dipstick and microscopy in diagnosis of urinary tract infections among under-fives presenting with fever to Nsambya hospital

2024-10-21T16:10:21Z

Predictive value of dipstick and microscopy in diagnosis of urinary tract infections among under-fives presenting with fever to Nsambya hospital Ocokoru, Christine Background: Urinary tract infection (UTI) is a common paediatric problem with the potential to cause long-term complications, globally. Children < 5 years often present with non-specific symptoms and signs making the diagnosis of urinary infection challenging. Fever may be the only sign of UTI in under-fives. Effective treatment depends on clinicians’ high index of suspicion and laboratory urine test results. Early diagnosis of UTI is essential to institute prompt treatment and reduce lifelong morbidity. Urine dipstick for nitrites and leucocyte esterase, and microscopy for leucocytes and bacteriuria are good screening tests to select urine specimens for culture which is the gold standard for UTI diagnosis. The screening tests provide more rapid information than urine culture, which could be utilized as decision-making tool for initiating treatment of UTI. Objective: To determine the predictive value of a combination of urine dipstick and microscopy in diagnosing UTI in children. Methodology: A cross-sectional study was conducted at the paediatric out patients’ department of Nsambya Hospital from December 2013 to April 2014.Children <5 years presenting with fever were approached and inquiries made about their prior antibiotic use. All children with temperatures ≥37.5⁰C and aged ≤59 months who had not been on antibiotic therapy 48 hours prior to hospital visit were enrolled into the study upon obtaining consent from their parents/caretakers. Basic information was filled in a data collection form. Two urine samples were collected from every participant-one for urine dipstick and microscopy and the other for urine culture. Data was entered in a computer using Epidata version 3.1 and analyzed using SPSS version 19 software. Findings: The sensitivity, specificity, positive predictive value and negative predictive value of combined urine dipstick and microscopy were 98.8%, 95%, 87.9% and 99.5% respectively. Urine dipstick alone had sensitivity of 46.9%, specificity 95.5%, positive predictive value of 79.2% and negative predictive value of 83.1%.Urine microscopy used alone had sensitivity of 95.1%, specificity 98.2%, positive predictive value 95.1% and negative predictive value of 98.2%. Conclusions: A combination of urine dipstick and microscopy is reliable in the diagnosis of UTI Recommendation: The MoH of Uganda should continue prioritizing the use of microscopy for the diagnosis of UTI among children under-five years of age. Nantulya Florence; Nannyonga Maria Musoke

Master of Medicine in Paediatrics (Dissertations)

Saccharomyces boulardii added to zinc in management of rotavirus gastroenteritis among children aged 3-36 months: A pilot study at Nsambya hospital

Predictive value of dipstick and microscopy in diagnosis of urinary tract infections among under-fives presenting with fever to Nsambya hospital