Related Experiment Videos
Intestinal permeability and diarrhoeal disease in Aboriginal Australians
R H Kukuruzovic1, A Haase, K Dunn
1NHMRC Centre of Clinical Excellence in Aboriginal Health, NT Clinical School, Flinders University and Royal Darwin Hospital, PO Box 41326, Casuarina, Darwin, NT 0811, Australia.
Insights
Aboriginal children in the Northern Territory show impaired intestinal function, indicated by higher lactulose to rhamnose ratios, linked to mucosal damage. This contributes to severe dehydration and electrolyte imbalances during acute gastroenteritis.
Area of Science:
- Pediatric Gastroenterology
- Indigenous Health Research
- Clinical Nutrition
Background:
- Northern Territory Aboriginal children experience high rates of acidosis, hypokalaemia, and dehydration during hospitalisation for acute gastroenteritis.
- Gastroenteritis in this population is associated with significant morbidity.
Purpose of the Study:
- To investigate differences in intestinal permeability between Aboriginal and non-Aboriginal children.
- To assess if increased intestinal permeability correlates with diarrhoea and associated complications in Aboriginal children.
Main Methods:
- A descriptive study involving 124 children (96 Aboriginal, 28 non-Aboriginal) hospitalised with or without diarrhoea.
- Intestinal permeability was measured using the lactulose to rhamnose (L-R) ratio from a 5-hour urine collection.
Main Results:
- Aboriginal children with diarrhoea had significantly higher mean L-R ratios (18.3) compared to those without diarrhoea (9.0) and non-Aboriginal children (5.9 with diarrhoea, 4.2 without).
- Elevated L-R ratios in diarrhoeal patients were strongly associated with acidosis, hypokalaemia, and dehydration (>5%).
Conclusions:
- The high incidence of severe complications in Aboriginal children with diarrhoeal disease is linked to underlying small intestinal mucosal damage.
- Intestinal permeability assessment is a valuable tool for understanding disease severity in pediatric gastroenteritis.
Background:
Northern Territory Aboriginal children hospitalised with acute gastroenteritis have high rates of acidosis, hypokalaemia, and dehydration.
Aims:
To determine whether Aboriginal children with and without diarrhoea have greater impairment in intestinal function than non-Aboriginal children, as assessed by increased permeability ratios.
Methods:
A descriptive study of 124 children (96 Aboriginal and 28 non-Aboriginal) hospitalised with and without diarrhoea. Intestinal permeability was assessed by the lactulose to rhamnose (L-R) ratio from a five hour urine collection.
Results:
In Aboriginal children, mean L-R ratios (95% confidence intervals) were 18.3 (17.1 to 19.6) with diarrhoea and 9.0 (7.3 to 11.0) without diarrhoea, and in non-Aboriginal children they were 5.9 (2.8 to 12. 3) and 4.2 (3.3 to 5.2), respectively. In patients with diarrhoea, L-R ratios were significantly raised when accompanied by acidosis (mean, 22.8; 95% CI, 17.0 to 30.5), hypokalaemia (mean, 20.7; 95% CI, 15.4 to 27.9), and >/= 5% dehydration (mean, 24.3; 95% CI, 19.0 to 29.6) compared with none of these complications (mean, 7.0; 95% CI, 3.5 to 13.8).
Conclusion:
The high incidence of acidosis, hypokalaemia, and dehydration in Aboriginal children admitted with diarrhoeal disease is related to underlying small intestinal mucosal damage.