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Green banana-supplemented diet in the home management of acute and prolonged diarrhoea in children: a community-based trial in rural Bangladesh.

  • 2010-08-04
  • Tropical medicine & international health : TM & IH 15(10)
    • G H Rabbani
    • C P Larson
    • R Islam
    • U R Saha
    • A Kabir

Study Design

Type
Randomized Controlled Trial (RCT)
Population
2968 Bangladeshi rural children 6-36 months old
Methods
Cluster randomized field trial, standard care plus green banana vs standard care alone, 14 days of surveillance
Blinding
Open-label
Duration
14 days
Funding
Unclear

Summary objective

To determine the effectiveness of green banana in the home management of acute (<7 days) or prolonged (≥ 7 days) diarrhoea at the community level.

Methods

A cluster randomized field trial was conducted among 2968 Bangladeshi rural children 6-36 months old. Wards (villages) were randomly assigned to either a standard care group or a standard care plus green banana group where mothers were instructed to add cooked green banana to the diets of diarrhoeal children. Through a village-based surveillance system, diarrhoeal morbidity data (severity, duration, compliance) were collected for 14 days. Treatment effects were determined by analysing cumulative probability of cure by testing Cox proportional hazards models and relative risk (RR).

Results

The cumulative probability of cure was significantly (P < 0.001) different in children receiving GB for both acute [hazard ratio (HR) = 0.63 (95% CI: 0.56-0.67)] and prolonged diarrhoea [HR = 0.38 (95% CI: 0.26-0.59)]. The recovery rates of children with acute diarrhoea receiving GB (vs. control) were significantly more by day 3: 79.9%vs. 53.3% [(RR) = 0.47, 95% CI: 0.41-0.55], (P < 0.001) and day 7: 96.6%vs. 89.1% (RR = 0.32; 0.22-0.46), (P < 0.001). Children with prolonged diarrhoea receiving green banana had significantly higher recovery rates by day 10: 79.8%vs. 51.9% (RR = 0.42; 0.23-0.73), (P < 0.001) and day 14: 93.6%vs. 67.2% (RR = 0.22; 0.08-0.54), (P < 0.001).

Conclusion

A green banana-supplemented diet hastened recovery of acute and prolonged childhood diarrhoea managed at home in rural Bangladesh.

Research Insights

  • green banana→Improved Diarrhea Recovery Rate

    and day 14: 93.6%vs. 67.2% (RR = 0.22; 0.08-0.54), (P < 0.001)

    Effect
    Beneficial
    Effect size
    Large
    Dose
    cooked green banana added to diet (amount not further specified)
  • green banana→Improved Recovery Rate

    The recovery rates of children with acute diarrhoea receiving GB (vs. control) were significantly more by day 3: 79.9%vs. 53.3% [(RR) = 0.47, 95% CI: 0.41-0.55], (P < 0.001)

    Effect
    Beneficial
    Effect size
    Large
    Dose
    cooked green banana added to diet (amount not further specified)
  • green banana→Reduced Diarrhea Rate

    Children with prolonged diarrhoea receiving green banana had significantly higher recovery rates by day 10: 79.8%vs. 51.9% (RR = 0.42; 0.23-0.73), (P < 0.001)

    Effect
    Beneficial
    Effect size
    Large
    Dose
    cooked green banana added to diet (amount not further specified)
  • green banana→Reduced Duration of Diarrhea

    The cumulative probability of cure was significantly (P < 0.001) different in children receiving GB for both acute ... diarrhoea [hazard ratio (HR) = 0.63 (95% CI: 0.56-0.67)]

    Effect
    Beneficial
    Effect size
    Large
    Dose
    cooked green banana added to diet (amount not further specified)

Adverse Events Reported

  • green banana→Overall tolerability

    No adverse events or safety findings were reported in the abstract.

    Finding
    Reported
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