R H Kukuruzovic1, A Haase, K Dunn, A Bright, D R Brewster. 1. NHMRC Centre of Clinical Excellence in Aboriginal Health, NT Clinical School, Flinders University and Royal Darwin Hospital, PO Box 41326, Casuarina, Darwin, NT 0811, Australia.
Abstract
BACKGROUND: Northern Territory Aboriginal children hospitalised with acute gastroenteritis have high rates of acidosis, hypokalaemia, and dehydration. AIMS: To determine whether Aboriginal children with and without diarrhoea have greater impairment in intestinal function than non-Aboriginal children, as assessed by increased permeability ratios. METHODS: A descriptive study of 124 children (96 Aboriginal and 28 non-Aboriginal) hospitalised with and without diarrhoea. Intestinal permeability was assessed by the lactulose to rhamnose (L-R) ratio from a five hour urine collection. RESULTS: In Aboriginal children, mean L-R ratios (95% confidence intervals) were 18.3 (17.1 to 19.6) with diarrhoea and 9.0 (7.3 to 11.0) without diarrhoea, and in non-Aboriginal children they were 5.9 (2.8 to 12. 3) and 4.2 (3.3 to 5.2), respectively. In patients with diarrhoea, L-R ratios were significantly raised when accompanied by acidosis (mean, 22.8; 95% CI, 17.0 to 30.5), hypokalaemia (mean, 20.7; 95% CI, 15.4 to 27.9), and >/= 5% dehydration (mean, 24.3; 95% CI, 19.0 to 29.6) compared with none of these complications (mean, 7.0; 95% CI, 3.5 to 13.8). CONCLUSION: The high incidence of acidosis, hypokalaemia, and dehydration in Aboriginal children admitted with diarrhoeal disease is related to underlying small intestinal mucosal damage.
BACKGROUND: Northern Territory Aboriginal children hospitalised with acute gastroenteritis have high rates of acidosis, hypokalaemia, and dehydration. AIMS: To determine whether Aboriginal children with and without diarrhoea have greater impairment in intestinal function than non-Aboriginal children, as assessed by increased permeability ratios. METHODS: A descriptive study of 124 children (96 Aboriginal and 28 non-Aboriginal) hospitalised with and without diarrhoea. Intestinal permeability was assessed by the lactulose to rhamnose (L-R) ratio from a five hour urine collection. RESULTS: In Aboriginal children, mean L-R ratios (95% confidence intervals) were 18.3 (17.1 to 19.6) with diarrhoea and 9.0 (7.3 to 11.0) without diarrhoea, and in non-Aboriginal children they were 5.9 (2.8 to 12. 3) and 4.2 (3.3 to 5.2), respectively. In patients with diarrhoea, L-R ratios were significantly raised when accompanied by acidosis (mean, 22.8; 95% CI, 17.0 to 30.5), hypokalaemia (mean, 20.7; 95% CI, 15.4 to 27.9), and >/= 5% dehydration (mean, 24.3; 95% CI, 19.0 to 29.6) compared with none of these complications (mean, 7.0; 95% CI, 3.5 to 13.8). CONCLUSION: The high incidence of acidosis, hypokalaemia, and dehydration in Aboriginal children admitted with diarrhoeal disease is related to underlying small intestinal mucosal damage.
Authors: I S Menzies; M J Zuckerman; W S Nukajam; S G Somasundaram; B Murphy; A P Jenkins; R S Crane; G G Gregory Journal: Gut Date: 1999-04 Impact factor: 23.059
Authors: Gwenyth O Lee; Benjamin J J McCormick; Jessica C Seidman; Margaret N Kosek; Rashidul Haque; Maribel Paredes Olortegui; Aldo A M Lima; Zulfiqar A Bhutta; Gagandeep Kang; Amidou Samie; Caroline Amour; Carl J Mason; Tahmeed Ahmed; Pablo Peñataro Yori; Domingos B Oliveira; Didar Alam; Sudhir Babji; Pascal Bessong; Estomih Mduma; Sanjaya K Shrestha; Ramya Ambikapathi; Dennis R Lang; Michael Gottlieb; Richard L Guerrant; Laura E Caulfield Journal: Am J Trop Med Hyg Date: 2017-07 Impact factor: 2.345