Folic acid in the treatment of acute watery diarrhoea in children: a double-blind, randomized, controlled trial D Mahalanabis 1 H Ashraf 2 MM Rahman

2 GJ Fuchs 2 1 Society for Applied Studies, Calcutta, India 2 International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka, Bangladesh Correspondence to H Ashraf, Clinical Sciences Division, ICDDR, B, Mohakhali, Dhaka 1212, Bangladesh Copyright 1998 Scandinavian University Press KEYWORDS Acute watery diarrhoea children folic acid

ABSTRACT
One-hundred and six male children aged 6-23 months with a history of acute watery diarrhoea of less than 72 h duration were randomized to receive either folic acid in a dose of 5 mg at 8-h intervals or placebo for 5 d. There were 54 children in the folic acid group and 52 in the placebo group. The admission characteristics were comparable between the two groups. No significant differences were observed in the intake of oral rehydration solution or stool output between the groups. The mean SD of total stool output (g kg1) was 532 476 vs 479 354 and the duration (h) of diarrhoea was 108 68 vs 103 53 in the folic acid vs placebo group, respectively. The findings, therefore, should have a positive influence on preventing the inappropriate use of folic acid in acute diarrhoea.

Received Oct. 13, 1997. Accepted in revised form Aug. 3, 1998

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Giardiasis: haematological status and the absorption of vitamin B12 and folic acid Karsten Hjelt 1 , Anders Prregaard 1 Peter A Krasilnikoff 1 1 Department of Paediatrics, University of Copenhagen, Gentofte Hospital, Hellerup, Denmark Correspondence to Department of Neonatology, University of Copenhagen, GN 5024, Rigshospitalet, Belgdamsvej, 2100 Copenhagen, Denmark Copyright 1992 Taylor & Francis KEYWORDS Giardia lamblia folic acid absorption iron vitamin B12 absorption

ABSTRACT
The haematological status, as well as the fractional absorptions of folic acid (FAFol) and vitamin B12 (FAB12) were studied in 29 children aged 0.713.5 years (mean 3.3 years) with

chronic diarrhoea due to giardiasis. Small intestinal biopsies revealed mucosal damage in 20 children; the biopsies of the remaining nine children were normal. At the initial investigation the FAFol and FAB12 values were below normal in approximately one-sixth and one-third of patients, respectively. Bacterial overgrowth of the small intestinal tract did not seem to play a role in FAB12 malabsorption. About one-fifth of patients had mild anaemia. None of the patients showed FAB12 insufficiency and only one patient suffered from folate depletion. At follow-up, FAFol, FAB12, haemoglobin and Erc-folate concentrations increased significantly while P-B12 and P-folate remained unchanged. Iron status, as well as dietary intake of iron, appeared insufficient prior to, as well as after treatment. Serum iron, transferrin saturation and haemoglobin concentrations were lower in patients who had acquired the disease abroad or suffered from persistent diarrhoea.

Submitted May 28, 1990. Accepted Dec. 30, 1990