ARTICLES--FOCUS ON MALNUTRITION Comparison of Milk and Maize Based Diets in Kwashiorkor

Casuarina NT 0811 AUSTRAUA The dual sugar test of intestinal permeability is a reliable non-invasive way of assessing the ~nse of the small intestinal mucosa to nutritional rehabilitation. Our aim was to compare a local mix of maize soya-egg to the standard milk diet in the mannent of kwashiorkor. . The diets were alternated three monthly in the sequence milk-maize-milk. There' were a toW' of 5,33 kwashiorkor' admissions of at least' five days durin, thc:, sruay'",I1(~' ~i#d;: either'milk or maize. IntestinaI permeabillty,Was,~ at weekly intervals by the lactulose-rhamnose test in 100 kwashiorkor cases, including 55 on milk and 45 on the maize diet. Permeability ratios (95% confidence interval) on the milk diet improved by a mean of 6.4 (1.7 to 11.1) compared with 6.8 (-16.8 to 5.0) in the maize group. The improved permeability on milk occurred despite more diarrhoea, which constituted 34.8% of hoSpital days compared to 243% in the maize group. '~f.1tality' rates :6>r aU533~iorkor admissions were 13.6% ,v 20,99fI, respect,iVe1y.givill~ a,.~~ tive rlSkof death in the maize group of 1.54 J.1,91,tg,f,~8L The maize group aisohad more clinic;:alsep$is.(6Q%:v31%)" and less weight gain (2.9 v 4.4 glkglday) than themiJlc group .. Milk is superior to a loc:aI maize based diet in the treatment of kwashiorkor in terms of mortality, weight gain, clinical sepsis, and improvement in intestinal permeability.