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Trimethoprim-sulfamethoxazole and metronidazole were used for 14 days to treat 20 children with small intestine bacterial overgrowth (SIBO). SIBO was diagnosed using the lactulose hydrogen breath test. The breath test was repeated 1 month after treatment, and 19 (95.0%) of 20 children showed no evidence of SIBO (P < 0.001). The area under the individual curves showed that children with SIBO exhibited greater hydrogen production before treatment in both the first hour and between 60 and 180 minutes after the breath test. The treatment did not decrease methane production. In conclusion, trimethoprim-sulfamethoxazole and metronidazole was effective in treating children with SIBO.

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AIM: To analyze small intestinal bacterial overgrowth in school-aged children and the relationship between hydrogen and methane production in breath tests. METHODS: This transversal study included 85 children residing in a slum and 43 children from a private school, all aged between 6 and 10 years, in Osasco, Brazil. For characterization of the groups, data regarding the socioeconomic status and basic housing sanitary conditions were collected. Anthropometric data was obtained in children from both groups. All children completed the hydrogen (H(2)) and methane (CH(4)) breath test in order to assess small intestinal bacterial overgrowth (SIBO). SIBO was diagnosed when there was an increase in H(2) ≥ 20 ppm or CH(4) ≥ 10 ppm with regard to the fasting value until 60 min after lactulose ingestion. RESULTS: Children from the slum group had worse living conditions and lower nutritional indices than children from the private school. SIBO was found in 30.9% (26/84) of the children from the slum group and in 2.4% (1/41) from the private school group (P = 0.0007). Greater hydrogen production in the small intestine was observed in children from the slum group when compared to children from the private school (P = 0.007). A higher concentration of hydrogen in the small intestine (P < 0.001) and in the colon (P < 0.001) was observed among the children from the slum group with SIBO when compared to children from the slum group without SIBO. Methane production was observed in 63.1% (53/84) of the children from the slum group and in 19.5% (8/41) of the children from the private school group (P < 0.0001). Methane production was observed in 38/58 (65.5%) of the children without SIBO and in 15/26 (57.7%) of the children with SIBO from the slum. Colonic production of hydrogen was lower in methane-producing children (P = 0.017). CONCLUSION: Children who live in inadequate environmental conditions are at risk of bacterial overgrowth and methane production. Hydrogen is a substrate for methane production in the colon.

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OBJETIVO:Avaliar a prevalência de parasitoses intestinais, correlacionando-as com os fatores socioeconômicos e ambientais, peso, estatura e hemoglobina, em crianças de dois estratos socioeconômicos, no município de Osasco (SP). MÉTODOS: Estudo transversal, comparando 84 crianças de seis a dez anos, residentes em área sem saneamento básico e moradia precária, com 35 crianças de escola particular no mesmo município, que possuíam boas condições socioeconômicas e de moradia. Excluíram-se aquelas com diarreia há menos de 30 dias ou doença grave. Utilizou-se questionário padronizado para avaliar as condições socioambientais. A avaliação nutricional foi realizada mediante escores Z de peso para idade, estatura para idade e índice de massa corpórea. A determinação da hemoglobina em amostra de sangue capilar foi realizada pelo método Hemocue® e a pesquisa de parasitas intestinais, pelos métodos de Hoffman, Ritchie, Kinyoun e swab anal. RESULTADOS: Parasitose intestinal ocorreu em 60,7 por cento das crianças da favela e em 5,9 por cento das crianças da escola particular (p<0,001; OR 24,7). A média dos escores Z de peso para idade, estatura para idade e índice de massa corpórea foi menor nas crianças parasitadas (-0,78±0,84; +0,50±0,90; -0,76±0,96) em relação àquelas não parasitadas (-0,18±1,18; +0,03±1,10; -0,28±1,16), sendo as diferenças estatisticamente significantes (p<0,05). Não houve diferença nos valores médios de hemoglobina entre as crianças parasitadas e não parasitadas do grupo da favela (12,6±1,1g/dL e 12,8±1,2g/dL); p=0,58. CONCLUSÕES: A parasitose intestinal foi mais prevalente em crianças da favela e se associou a menores índices de peso e de estatura.

OBJECTIVE:To evaluate the association between the prevalence of intestinal parasitosis with socioeconomic and environmental factors, as well as with weight, height and hemoglobin levels in two different socioeconomic groups of children in Osasco (SP), Brazil. METHODS: This cross-sectional study compared 84 children aged from six to ten years old from a slum area without proper sanitation and poor housing with 35 children attending private school with good socioeconomic level and housing conditions in the same city. Children with diarrhea for less than 30 days or severe illness were excluded. A standard questionnaire was applied for assessing social and environmental conditions. The nutritional assessment was done by Z scores for weight for age, height for age and body mass index. Capillary blood hemoglobin determination was done by HemoCue® method and intestinal parasitosis examination was performed by the Hoffman, Ritchie, Kinyoun and anal swab methods. RESULTS: Intestinal parasitosis occurred in 60.7 percent of children from the slum and in 5.9 percent of children from private schools (p<0.001; OR 24.7). The average Z scores of weight for age, height for age and body mass index were lower in infected children (-0.78±0.84; +0.50±0.90; -0.76±0.96) compared to non infected children (-0.18±1.18; +0.03±1.10; -0.28±1.16) with statistical differences (p<0.05). There was no difference in average hemoglobin levels between infected and non infected children by intestinal parasitosis in the slum group (12.6±1.1g/dL and 12.8±1.2g/dL); p=0.58. CONCLUSIONS: Intestinal parasitosis were more prevalent among children from the slum and were associated with lower weight and height.

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