Peer-reviewed article
Effect of Nitazoxanide and Probiotic Treatment on Bangladeshi Children with Cryptosporidiosis.
Zannatun Noor, Biplob Hossain, Nishad Tasnim Mithila, Amena Khatun, Sultan Mahmud et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested whether combining an antiparasitic drug (nitazoxanide) with a probiotic (Lactobacillus reuteri) could help malnourished Bangladeshi children clear a parasitic infection called cryptosporidiosis and improve their growth. Sixty-four children with the infection and malnutrition were randomly divided into three groups: one receiving both treatments, one receiving only the drug, and one receiving standard care. The results showed no benefit from either treatment or their combination compared to standard care in reducing how long children stayed infected or in improving their growth.
Key points
- Cryptosporidium infection causes diarrhea and can stunt growth, particularly in malnourished children
- The study enrolled 64 undernourished Bangladeshi children with confirmed cryptosporidiosis
- Neither nitazoxanide alone, probiotic alone, nor their combination reduced infection duration or improved anthropometric measurements compared to control
- The pilot study does not support the tested treatments as effective for reducing infection or improving growth in growth-stunted children
Limitations
This is a small pilot study with an unequal control group (n=10 vs 26-28 in treatment groups), which may limit the ability to detect differences. The document does not clarify the duration of follow-up or potential reasons why the treatments did not work as hypothesized.
Abstract
Cryptosporidium spp. is a cause of diarrhea morbidity and mortality in children under 5 years of age. In addition, asymptomatic infections can have a negative impact on growth and development. In low- and middle-income countries where a greater number of infants may be malnourished, the results of treating cryptosporidiosis with the only Food and Drug Administration-approved drug nitazoxanide (NTZ) have been inconsistent. Malnutrition is both a risk factor for cryptosporidiosis and a consequence of infection with this parasite. Treatment with the probiotic Lactobacillus reuteri DSM 17938 has been shown to assist in nutritional recovery and the restoration of gut health. In this pilot randomized clinical trial, we examined whether combined probiotic and NTZ treatment could result in the reduction in parasitemia and infection-associated growth stunting in undernourished children. Cryptosporidium spp.-positive Bangladeshi children with a weight-for-length Z score between -1 and -3 were randomly assigned to one of three groups. Group 1 (n = 26) received NTZ and Lactobacillus, group 2 (n = 28) received NTZ along with a placebo, and the third control group (n = 10) received standard care. There was no difference in the duration of infection or improvement in child anthropometric measurements in any treatment group compared with control. Therefore, this pilot study does not provide support for treatment with NTZ, Lactobacillus, or the two in combination as an effective means of reducing the duration of Cryptosporidium spp. infection or improving growth in growth-stunted children.