Pediatric Infectious Disease JournalŪ
Green Banana Reduces Clinical Severity of Childhood
Shigellosis: A Double-blind, Randomized, Controlled Clinical Trial
of Article: http://www.medscape.com/viewarticle/704181
Golam H. Rabbani, MD, PhD, FACG; Shamsir Ahmed, MBBS; Md. Iqbal
Hossain, MBBS, PhD; Rafiqul Islam, MBBS, MPH; Farzana Marni, MSc; Mastura
Akhtar, MSc; Nashiha Majid, MSc
Background and Aims: Mature green banana (GB) fruit is
rich in amylase-resistant starch that stimulates colonic production of
short-chain fatty acids (referred to as fatty acid) and is useful in treating
diarrheal diseases. We studied therapeutic effects of GB in childhood
shigellosis by determining colonic fatty acid production in a double-blind,
randomized, controlled, clinical trial.
Methods: Seventy-three children aged 6 to 60 months with severe bloody
dysentery caused by Shigella infection were either given a rice-based
diet (54 kcal/dL), with cooked GB (250 g/L) (n = 34) or without GB (n = 39)
for 5 days; all given ciprofloxacin (15 mg/kg, q12 hours). Stool volume,
frequency, excretion of blood/mucus, and relevant clinical and laboratory
indices were determined.
Results: On day 5 (post-treatment), 59% children in GB group had no
mucus compared with 36% in controls, fecal blood was completely cleared from
96% in GB group compared with 60% without GB (P < 0.05). GB
treatment significantly reduced (P < 0.01) numbers of stools/day
compared with controls (70% vs. 50%, P < 0.05). GB-specific
reductions of mean fecal volumes (mL/kg) ranged from 25% to 40%; (P
< 0.05) during the 5-day observations. Clinical success rates were 85% in
GB group compared with 67% in controls (P < 0.05). GB significantly
(P < 0.01) reduced fecal myeloperoxidase activity and increased
fecal fatty acid concentrations (P < 0.01).
Conclusions: GB diet improves clinical severity in childhood
shigellosis and could be a simple and useful adjunct for dietary management
of this illness.