Selenium for acute watery diarrhea in children

  • Meiviliani Sinaga Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik General Hospital, Medan, North Sumatera
  • Supriatmo Supriatmo Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik General Hospital, Medan, North Sumatera
  • Rita Evalina Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik General Hospital, Medan, North Sumatera
  • Ade Rachmat Yudiyanto Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik General Hospital, Medan, North Sumatera
  • Atan Baas Sinuhaji Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik General Hospital, Medan, North Sumatera
Keywords: acute watery diarrhea, selenium, frequency diarrhea, stool consistency

Abstract

Background Acute watery diarrhea remains a major health problem affecting infants and children in developing countries. Selenium deficiency may be a risk factor for diarrhea and vice versa. Few studies have been conducted on the effectiveness of selenium for the treatment of diarrhea in children.
Objective To determine the effectiveness of selenium in reducing the severity of acute watery diarrhea in children.
Methods A single-blind, randomized clinical trial was done in children with acute watery diarrhea, aged six months to two years, and who visited the community health center in Simalungun from May to August 2012. Children were randomized into either the selenium or placebo (maltodextrin) group. We monitored diarrheal frequency, stool consistency, and duration of diarrhea. Mann-Whitney, Fisher’s, and Kolmogorov-Smirnov tests were used to compare the two groups.
Results Sixty-five children were recruited into the study, of whom 36 children received selenium and 29 children received a placebo. The selenium group had significantly lower frequency of diarrhea (bouts per day) than the placebo group on days 2, 3, and 4 after treatment onset [day 2: 3.5 vs. 4.1, respectively (P=0.016); day 3: 2.7 vs. 3.4, respectively (P=0.002); day 4: 2.1 vs. 2.8, respectively (P<0.001)]. On day 2, stool consistency had significantly improved in the selenium group compared to the placebo group (P=0.034). In addition, the median duration of diarrhea was significantly lower in the selenium group than in the placebo group (60 vs. 72 hours, respectively; P=0.001). Median recovery time from the the first day of diarrhea was also significantly lower in the selenium group than in the placebo group (108 vs. 120 hours, respectively; P=0.009).
Conclusion In children with acute watery diarrhea, those treated with selenium have decreased frequency of diarrhea, improved stool consistency, as well as shorter duration of diarrhea and recovery time than those treated with a placebo. [Paediatr Indones. 2016;56:139-43.].

References

1. Soenarto Y, Jufrie M. Tatalaksana diare pada anak. Proceedings of the Workshop of Diarrhea Management, 2007 June 7-10; Medan. p. 1-51
2. Ministry of Health Republic of Indonesia. Situasi diare di Indonesia 2011. Jakarta: Ministry of Health Republic of Indonesia; 2011. p. 1-38
3. Brown KH. Diarrhea and malnutrition. J Nutr. 2003;133: 328S-332S.
4. Olmez A, Yalcin S, Yurdakok K, Coskun T. Serum selenium levels in acute gastroenteritis of possible viral origin. J Trop Pediatr. 2004;50:78-81.
5. Bhardwaj P. Oxidative stress and antioxidants in gastrointestinal diseases. Trop Gastroenterol. 2008;29:129-35.
6. Stojiljkovic V, Todorovic A, Pejic S, Kasapovic J, Saicic Z, Radlovic N, et al. Antioxidant status and lipid peroxidation in small intestinal mucosa children with celiac disease. Clin Biochem. 2009;42:1431-37.
7. Hidajat B. Penggunaan antioksidan pada anak. Proceedings of the Continuing Education Ilmu Kesehatan XXXV Kapita Selekta Ilmu Kesehatan Anak IV “Hot topic in pediatrics;” 2005 September 3-4; Surabaya. p. 1-10.
8. Sunde RA. Selenium. In: Bowman BA, Russell RM, editors. Present knowledge in nutrition. 9th ed. Washington, DC: ILSI Press; 2006. p. 480-97.
9. Kiremidjian- Schumacher L, Roy M, Wishe HI, Cohen MW, Stotzky G. Regulation of cellular immune responses by selenium. Biol Trace Elem Res. 1992;33:23-35.
10. Kiremidjian-Schumacher L, Roy M, Wishe HI, Cohen MW, Stotzky G. Selenium and immune cell functions. Effect on lymphocyte proliferation and production of interleukin 1 and interleukin 2. Proc Soc Exp Biol Med. 1990;193:136-42.
11. WHO. The treatment of diarrhoea: a manual for physician and other senior health workers. 4th rev. Geneva: WHO Press; 2005. p. 1-43
12. Thomas AG, Miller V, Shenkin A, Fell GS, Taylor F. Selenium and gluthathione peroxidase status in paediatric health and gastrointestinal disease. J Pediatr Gastroenterol Nutr. 1994;19:213-9.
13. Ramig RF. Pathogenesis of intestinal and systemic rotavirus infection. J Virol. 2004;78:10213-20.
14. Corwin AL, Subekti D, Sukri NC, Willy RJ, Master J, Priyanto E, et al. A large outbreak of probable rotavirus in Nusa Tenggara Timur, Indonesia. Am J Trop Med Hyg. 2005; 72:488-94.
15. Nieto N, Lopez-Pedrosa JM, Mesa MD, Torres MI, Fernandez MI, Rios A, et al. Chronic diarrhea impairs intestinal antioxidant defense system in rats at weaning. Dig Dis Sci. 2000;45:2044-50.
16. Andrews ED, Hartley WJ, Grant AB. Selenium-responsive diseases of animals in New Zealand. N Z Vet J. 1968;16:3-17.
17. Teige J, Tollersrud S, Lund A, Larsen HJ. Swine dysentery: the influence of dietary vitamin E and selenium on the clinical and pathological effects of Treponema hyodysenteria infection in pigs. Res Vet Sci. 1982;32:95-100.
18. Subagyo B, Santoso NB. Diare akut. In: Juffrie M, Soenarto SY, Oswari H, Arief S, Rosalina I, et al., editors. Buku ajar gastroenterologi-hepatologi. 1st ed. Jakarta: IDAI; 2010. p. 87-120.
19. Litov RE, Combs GF. Selenium in pediatric nutrition. Pediatrics. 1991;87:339-51.
Published
2016-07-01
How to Cite
1.
Sinaga M, Supriatmo S, Evalina R, Yudiyanto A, Sinuhaji A. Selenium for acute watery diarrhea in children. PI [Internet]. 1Jul.2016 [cited 22Nov.2024];56(3):139-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/227
Section
Pediatric Gastrohepatology
Received 2016-08-18
Accepted 2016-08-18
Published 2016-07-01