Pneumonia Clinical Trial
Official title:
64N Nutraceutical for the Prevention of Childhood Diarrhea and Pneumonia in Low Resource Settings
The purpose of this study is to compare the occurrence of childhood diarrheal disease and pneumonia in subjects under the age of 5 years in low resource settings who have received prophylactic 64N nutraceutical (64N)as a neonate as compared with neonates who have not received prophylactic 64N.
Diarrheal disease and pneumonia are two of the top four causes of mortality in children
under the age of five . In 2010, 64 percent of deaths in this age group were due to
infectious causes. A majority of these deaths occur in developing countries. Although
vaccines have been proven to prevent pneumonia and diarrheal disease due to rotavirus, these
vaccines may not be available to the most vulnerable children in developing countries.
Barriers to vaccination in the poorest countries include lack of infrastructure, poor health
systems, lack of finances, and lack of transportation. It has been estimated that an
additional one billion US dollars will be needed to guarantee that the most vulnerable
populations receive vaccinations.
Diarrheal disease is especially problematic since pathogens other than rotavirus cause
diarrhea in children living in developing countries. Examples of pathogens causing diarrhea
include Vibrio cholera, Salmonella enterica serovar Typhi, Escherichia coli [E. coli],
Cryptosporidium, Entamoeba histolytica, and Shigella. Parasitic worms of the Schistosoma
genus also cause diarrheal disease in poor countries. In developing countries, infants 0 to
11 months of age are at the highest risk of dying from diarrhea caused by typical E. coli
and E. coli producing heat-stable toxin. Children 12 to 23 months of age are at the highest
risk of dying from diarrhea caused by Cryptosporidium. It has been recommended that five
pathogens (i.e., typical E. coli, E. coli producing heat-stable toxin, Cryptosporidium,
Shigella, rotavirus) be targeted in order to decrease the burden of moderate-to-severe
childhood diarrhea in developing countries.
In order to improve survival for children under the age of five in low resource settings,
cost-effective, patient-directed, accessible, innovative, and alternative interventions that
are culturally appropriate need to be explored. One such intervention that may confer
passive immunity to protect young children in low resource settings against the multiple
pathogenic causes of childhood diarrhea as well as childhood pneumonia is the utilization of
64N.
64N has been used by Ayurvedic physicians for medicinal purposes in humans in India and was
also commonly used in Western medicine prior to the development of penicillin and other
manufactured antibiotics. Both hyperimmune 64N and unadulterated 64N have been studied in
children. Infants fed defatted hyperimmune 64N significantly decreased diarrhea due to
rotavirus as compared with infants who received milk from the market. In children 3 to 15
months of age, 64N decreased rotavirus infection as compared with artificial infant formula.
Treatment studies have also shown a benefit of 64N for diarrhea. In children presenting with
diarrhea due to E. coli, administration of 64N significantly decreased stool frequency as
compared with placebo. 64N concentrates were found to be effective in the treatment of
infants with hemorrhagic diarrhea and stopped the progression of the disease to hemolytic
urea syndrome. 64N has also been studied in children (1 to 10 years of age) who had mild to
moderate nonorganic failure to thrive. In this randomized controlled trial, the authors
found that the Gomez index (a weight for age index) was significantly improved with 3 months
of 64N supplementation as compared with no 64N supplementation.
There are few side effects of 64N. These are limited to lactose intolerance and sensitivity
to milk proteins.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Prevention
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