Sabir Khan, Saira Uzma, Zia Muhammad, Syed Imad Ali Shah, Irshad Ahmad.
Frequency of Secondary Lactose Intolerance in Children with Severe Acute Malnutrition with Diarrhoea.
J Med Sci Jan ;26(4):326-30.

Objective: To determine the frequency of lactose intolerance in children with severe acute malnutrition presenting with diarrhea. Material and method: This study was conducted in nutritional rehabilitation unit, Khyber teaching hospital Peshawar from June 2014 to December 2014. It was a descriptive cross sectional study comprising of 150 paediatric patients ranging from 5 months to 5 years of age who met the WHO criteria of acute severe malnutrition having Z-score of <-3SD with weight for height/length, age and sex presenting with diarrhea. Then stool was tested for reducing substances in freshly collected sample. Results: Of the total 150 patients of 5-60 months of age (mean age 17.7±11.91 SD), 82(54.7%) were male and 68(45.3%) were female. Overall 41(27.3%) were lactose intolerant (having diarrhea with positive stool reducing substances) among them 21 were male (51.2%) while 20 were female (48.7%), 32 patients (78.04%) were having kwashiorkor and 9 patients (21.9%) were marasmic. Perianal rash, abdominal distention were present in 37 (90.2%) and, 38 (92.6 %) patients respectively. The findings which were significantly observed in children with lactose intolerance were edematous malnutrition (p-value 0.003), perianal rash (p-value 0.00), and abdominal distention (p-value 0.00). Conclusion: Secondary lactose intolerance is a common problem of children with acute severe malnutrition presenting with diarrhea. Clinical signs of lactose intolerance in severely malnourished children are perianal excoriation of skin and abdominal distention.

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