A COMPARATIVE EVALUATION ON THE EFFECT OF ZINC-PROBIOTIC AND PROBIOTIC THERAPY IN PAEDIATRIC ACUTE DIARRHOEA AND THE IMPACT OF COUNSELLING OF MOTHERS

Objective: To compare the efficacy of zinc-probiotic combination therapy and probiotic therapy alone in the treatment of acute paediatric diarrhoea and to assess the knowledge, attitude and practice (KAP) of the mothers of affected children and the impact of counselling on diarrhoea management.Methods: A prospective observational comparative study was conducted from October 2014 to March 2015 in the paediatric department of Cosmopolitan Hospitals Pvt. Ltd., Thiruvananthapuram, Kerala, South India. The study was carried out on 150 patients between the ages of 3 mo to 12 y. The selected patients were divided into 2 groups of 75 members each. Initially, demographic data, details of socioeconomic status, severity, duration and frequency of diarrhoea and the presence of other associated symptoms and KAP of mothers before and after counselling was collected by using specially designed proforma. Group 1 patients received zinc and probiotic and Group 2 received probiotic only by oral administration. All children in both groups received sufficient quantity of oral rehydration solution (ORS). The requirement of other medications and adverse effects were also monitored.Results: The study revealed that, in group 1, 54.6% of patients were males and in group 2, 58.6% were females. The mean age of affected children was 5.14±3.53. In both groups, the majority of patients were from outpatient (OP) departments. In group 1, majority of patients, 49.3% were resting in upper lower economic class followed by 30.7% were lower middle class. In the case of group 2, 34.6% patients were from lower middle and 28% were from upper middle class. Other medications such as antiemetic and antipyretic were administered to 127and 110 patients respectively. Antisecretory and antibiotic were administered to 31 and 26 patients respectively. Totally 8 patients were affected with adverse drug reactions such as rashes and swelling of lips. In both groups severity of diarrhoea was high before treatment and it was changed after effective treatment with drugs. Comparing with group 2, the duration and severity of diarrhoea and other associated symptoms in group 1 patients were significantly reduced after treatment. Before counseling, the majority of mothers had very poor knowledge about the diarrhoeal disease and its management. Evaluation after counselling showed a significant improvement.Conclusion: Low socioeconomic life is a risk factor for diarrhoea. A combination of zinc and probiotic therapy is more effective than probiotic therapy alone in the treatment of acute diarrhoea and vomiting in children. The emergence and severity of the diarrhoeal disease can be reduced by effective clinical pharmacist interventions, and a great emphasis is needed in the counselling and education of mothers about this disease and its management.Keywords: Paediatric diarrhoea, Zinc, Probiotic, KAP, Counselling and educatio