Tan Michelle Li Nien, Muhardi Leilani, Osatakul Seksit, Hegar Badriul, Vandenplas Yvan, Ludwig Thomas, Bindels Jacques, Van der Beek Eline M, Quak Seng Hock
Department of Pediatrics, National University of Singapore, Singapore.
Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
Pediatr Gastroenterol Hepatol Nutr. 2018 Jul;21(3):170-175. doi: 10.5223/pghn.2018.21.3.170. Epub 2018 Jun 28.
Lactose intolerance (LI) is perceived to be frequent in Asia and has been reported to have considerable impact on dietary intake, nutritional status and the quality of life. We aimed to gather information from healthcare professionals on the perceived incidence, diagnosis and management of LI in 1 to 5 year old children in Southeast Asia.
An anonymous electronic survey was sent randomly among healthcare professionals registered in the database of the pediatric societies in Thailand, Indonesia, and Singapore between June and October 2016.
In total, 259 health care professionals responded of which 45.5% (n=118) were from Thailand, 37.4% (n=97) from Indonesia and 16.9% (n=44) from Singapore. Of the participants who responded (n=248), primary LI prevalence among children 1 to 3 years of age was estimated to be less than 5% by 56.8%. However, about 18.9% (n=47) answered they did not know/unsure. Regarding secondary LI, 61.6% of respondents (n=153) estimated the prevalence to be less than 15%. But again, 10.8% (n=27) answered they did not know or unsure. Rotavirus gastroenteritis was ranked as the top cause for secondary LI. There was considerable heterogeneity in the diagnostic methods used. The majority of respondents (75%) recommended lactose-free milk to manage primary and secondary LI.
More education/training of pediatricians on this topic and further epidemiological studies using a more systematic approach are required.
乳糖不耐受(LI)在亚洲被认为很常见,据报道对饮食摄入、营养状况和生活质量有相当大的影响。我们旨在收集东南亚地区医疗保健专业人员关于1至5岁儿童乳糖不耐受的感知发病率、诊断和管理方面的信息。
2016年6月至10月期间,在泰国、印度尼西亚和新加坡儿科协会数据库中注册的医疗保健专业人员中随机发送了一份匿名电子调查问卷。
共有259名医疗保健专业人员回复,其中45.5%(n = 118)来自泰国,37.4%(n = 97)来自印度尼西亚,16.9%(n = 44)来自新加坡。在回复的参与者(n = 248)中,56.8%估计1至3岁儿童原发性乳糖不耐受的患病率低于5%。然而,约18.9%(n = 47)回答他们不知道/不确定。关于继发性乳糖不耐受,61.6%的受访者(n = 153)估计患病率低于15%。但同样,10.8%(n = 27)回答他们不知道或不确定。轮状病毒肠胃炎被列为继发性乳糖不耐受的首要原因。所使用的诊断方法存在相当大的异质性。大多数受访者(75%)推荐无乳糖牛奶来管理原发性和继发性乳糖不耐受。
需要对儿科医生进行更多关于该主题的教育/培训,并采用更系统的方法进行进一步的流行病学研究。