Research: Pakistan

Karachi, PAKISTAN

Growth faltering, diarrhea and nutrient deficiencies that occur at the time of weaning are important public health problems. In a joint project with the Department of Pediatrics and Research of Aga Khan University Hospital, we are investigating the feasibility of using probiotics in the form of Lactobacillus GG (LGG) to reduce these weaning problems. The study is taking place at Bilal Colony, an urban community in Korangi town, Karachi. The population of Bilal Colony is multiethnic and its main source of livelihood is served by industrial establishments in the vicinity.

The study aims to:

• demonstrate the feasibility of recruiting, following, and monitoring a birth cohort of 100 infants in an urban community in Karachi, Pakistan, as well as our ability to deliver the probiotic Lactobacillus GG (LGG) in yogurt to infants during daily home visits.
• obtain pilot data in this population of children on the age of weaning, rates of diarrhea pre- and post-weaning, rates of growth faltering pre- and post-weaning, preliminary efficacy of LGG in preventing diarrheal disease and growth faltering in these children, and serum levels of micronutrients pre- and post-weaning.

While LGG has been shown to be of benefit in reducing the burden of diarrheal disease in several small studies, there have been no large clinical trials of LGG that examine the long-term outcomes, such as prevention of growth faltering, frequency and duration of diarrheal disease, intestinal function and micronutrient status. Nor has LGG been studied prospectively when initiated at the time of weaning. We will plan a clinical trial to test these questions, using the feasibility and preliminary data obtained in this study.