Pediatr Gastroenterol Hepatol Nutr.  2018 Jul;21(3):170-175. 10.5223/pghn.2018.21.3.170.

An Electronic Questionnaire Survey Evaluating the Perceived Prevalence and Practices of Lactose Intolerance in 1 to 5 Year Old Children in South East Asia

Affiliations
  • 1Department of Pediatrics, National University of Singapore, Singapore. michelle_ln_tan@nuhs.edu.sg
  • 2Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
  • 3Danone Nutricia Early Life Nutrition, Nutricia Research, Singapore.
  • 4Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hatyai, Thailand.
  • 5Department of Pediatrics, Faculty of Medicine, University of Indonesia, Debok, Indonesia.
  • 6Department of Pediatrics, Universitair Ziekenhuis Brussels, Brussels, Belgium.
  • 7Danone Nutricia Early Life Nutrition, Nutricia Research, Utrecht, the Netherlands.
  • 8Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Abstract

PURPOSE
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.
METHODS
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.
RESULTS
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.
CONCLUSION
More education/training of pediatricians on this topic and further epidemiological studies using a more systematic approach are required.

Keyword

Lactose intolerance; Primary; Secondary; Management; Survey; Healthcare providers; South East Asia

MeSH Terms

Anonyms and Pseudonyms
Asia
Asia, Southeastern
Child*
Delivery of Health Care
Diagnosis
Epidemiologic Studies
Far East*
Gastroenteritis
Health Personnel
Humans
Incidence
Indonesia
Lactose Intolerance*
Lactose*
Milk
Nutritional Status
Population Characteristics
Prevalence*
Quality of Life
Rotavirus
Singapore
Surveys and Questionnaires
Thailand
Lactose

Reference

1. Heyman MB. Committee on Nutrition. Lactose intolerance in infants, children, and adolescents. Pediatrics. 2006; 118:1279–1286.
Article
2. Lukito W, Malik SG, Surono IS, Wahlqvist ML. From ‘lactose intolerance’ to ‘lactose nutrition’. Asia Pac J Clin Nutr. 2015; 24:Suppl 1. S1–S8.
3. Wahlqvist ML. Lactose nutrition in lactase nonpersisters. Asia Pac J Clin Nutr. 2015; 24:Suppl 1. S21–S25.
4. Perino A, Cabras S, Obinu D, Cavalli Sforza L. Lactose intolerance: a non-allergic disorder often managed by allergologists. Eur Ann Allergy Clin Immunol. 2009; 41:3–16.
5. EFSA Panel on Dietetic Products NaAN. Scientific opinion on lactose thresholds in lactose intolerance and galactosaemia. EFSA J. 2010; 8:1777.
6. Harvey L, Ludwig T, Hou AQ, Hock QS, Tan ML, Osatakul S, et al. Prevalence, cause and diagnosis of lactose intolerance in children aged 1–5 years: a systematic review of 1995–2015 literature. Asia Pac J Clin Nutr. 2018; 27:29–46.
7. Hegar B, Widodo A. Lactose intolerance in Indonesian children. Asia Pac J Clin Nutr. 2015; 24:Suppl 1. S31–S40.
8. Braithwaite D, Emery J, De Lusignan S, Sutton S. Using the Internet to conduct surveys of health professionals: a valid alternative? Fam Pract. 2003; 20:545–551.
Article
9. GBD 2015 SDG Collaborators. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet. 2016; 388:1813–1850.
10. Myo-Khin , Bolin TD, Khin-Mar-Oo , Tin-Oo , Kyaw-Hla S, Thein-Myint T. Ineffectiveness of breath methane excretion as a diagnostic test for lactose malabsorption. J Pediatr Gastroenterol Nutr. 1999; 28:474–479.
Article
11. Yang Y, He M, Cui H, Bian L, Wang Z. The prevalence of lactase deficiency and lactose intolerance in Chinese children of different ages. Chin Med J (Engl). 2000; 113:1129–1132.
12. Gonzalez-Galan V, Sánchez-Fauqier A, Obando I, Montero V, Fernandez M, Torres MJ, et al. High prevalence of community-acquired norovirus gastroenteritis among hospitalized children: a prospective study. Clin Microbiol Infect. 2011; 17:1895–1899.
Article
13. Hu Y, Gui L, Chang J, Liu J, Xu S, Deng C, et al. The incidence of infants with rotavirus enteritis combined with lactose intolerance. Pak J Pharm Sci. 2016; 29:1 Suppl. 321–323.
14. Fischer Walker CL, Black RE. Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size. BMC Public Health. 2011; 11:Suppl 3. S16.
Article
15. Vandenplas Y. Lactose intolerance. Asia Pac J Clin Nutr. 2015; 24:Suppl 1. S9–S13.
16. Newcomer AD, McGill DB, Thomas PJ, Hofmann AF. Prospective comparison of indirect methods for detecting lactase deficiency. N Engl J Med. 1975; 293:1232–1236.
Article
17. Schirru E, Corona V, Usai-Satta P, Scarpa M, Cucca F, De Virgiliis S, et al. Decline of lactase activity and c/t-13910 variant in Sardinian childhood. J Pediatr Gastroenterol Nutr. 2007; 45:503–506.
Article
18. Gremse DA, Greer AS, Vacik J, DiPalma JA. Abdominal pain associated with lactose ingestion in children with lactose intolerance. Clin Pediatr (Phila). 2003; 42:341–345.
Article
19. Wiley AS. Consumption of milk, but not other dairy products, is associated with height among US preschool children in NHANES 1999–2002. Ann Hum Biol. 2009; 36:125–138.
Article
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