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

Abstract

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.