Lactose malabsorption in Central Australian Aboriginal children hospitalized with acute enteritis

Abstract

The prevalence and duration of lactose malabsorption was studied in 64 Central Australian Aboriginal children requiring hospitalization for acute enteritis. Lactose malabsorption was determined by the breath-hydrogen test. Sixty-nine per cent were shown to malabsorb lactose, a figure similar to that for well nourished urban European children, hospitalized for acute enteritis. Whereas 90 per cent of the European children became lactose-tolerant 1 month later, only three of 32 aboriginal children were lactose-tolerant after 3 months. Lactose malabsorption was also associated with more frequent hospitalizations in affected children.Coronavirus-like particles were the commonest agent isolated from Aboriginal children. The majority of the Aboriginal children were malnourished (< 80% standard weight for age) which may have been contributed to by their lactose malabsorption and explain why this failed to recover in the same way as European children. The possibility of lactose malabsorption must be taken into consideration when managing Aboriginal children with acute diarrhoea1 disease and undernutrition. The use of the breath-hydrogen test allows an accurate diagnosis of lactose malabsorption to be made in Aboriginal children with diarrhoea so that appropriate dietary management can be instituted.

The Role of Nutrition in COVID-19 Susceptibility and Severity of Disease: A Systematic Review

“…Human enteric CoV causes moderate to severe villous atrophy in animal models, with virus particles visible in enterocytes of the large and small intestine ( 36 , 37 ). CoV-like particles have also been found in degenerating jejunal epithelial cells of adults in India with histological evidence of malabsorption due to environmental enteric dysfunction and among Aboriginal children with lactose malabsorption post-gastroenteritis ( 38 , 39 ). However, the exact mechanisms of COVID-19–induced gastrointestinal symptoms of nausea, vomiting, and loss of taste remain elusive ( 40 ).…”

Could nutrition modulate COVID-19 susceptibility and severity of disease? A systematic review

“…Human enteric coronavirus causes moderate to severe villous atrophy in animal models with virus particles visible in enterocytes of large and small intestine 45,46 . Coronavirus-like particles have also been found in degenerating jejunal epithelial cells of adults in India with histological evidence of malabsorption due to environmental enteric dysfunction and among Aboriginal children with lactose malabsorption post gastroenteritis 47,48 . However, the exact mechanisms of COVID-19 induced gastrointestinal symptoms of nausea, vomiting and loss of taste remain elusive 49 .…”

Milk formulas in acute gastroenteritis and malnutrition: A randomized trial

“…Aboriginal children from remote communities in northern Australia have high rates of hospital admission for diarrhoea and failure to thrive 1 . Diarrhoeal disease in Aboriginal children is frequently complicated by lactose intolerance, 2 leading to osmotic diarrhoea, acidosis, hypokalaemia and severe dehydration, requiring urgent air evacuation to hospital in Darwin. In a previous study, we showed that these complications are related to the severity of small bowel mucosal damage and that apparently healthy Aboriginal children have an underlying tropical/environmental enteropathy 3 .…”

“…Two ran­domized trials in the 1970s in Aboriginal children admitted with diarrhoea and/or malnutrition showed significantly greater weight gain on low‐lactose milk compared to normal milk 6,7 . In addition, a breath hydrogen study found that 90% of Aboriginal children under 2 years of age were still lactose intolerant 3 months after admission with acute gastroenteritis, compared to only 10% of non‐Aboriginal subjects 2 …”