PREVALENCE OF LACTOSE INTOLERANCE IN A-SYMPTOMATIC SCHOOL CHILDREN IN                KARACHI PAKISTAN: IS IT A PREDICTOR OF UNDER NUTRITION?

ABSTRACT

Aims: Lactose intolerance is an important indicator of under nutrition, as studied in many setting. However there is very limited literature available in Pakistan. High prevalence of lactose intolerance and mal-absorption in Asian Children and their link with high incidence of under-nutrition in our part of world needs to be investigated and understood.

Objectives:

1.   To determine the prevalence of lactose intolerance in asymptomatic children of 5-15 years of age attending Schools in Ibrahim Hydri, Karachi, Pakistan. 

2.   To determine the peak age group, which is most susceptible to lactose intolerance in children of 05 years to 15 years of age?

3.   To assess the association of lactose intolerance with under-nutrition in these children.

Subjects & Methods: This was a cross sectional study where a randomly selected 220 children of school going age in 2 schools of Karachi were provided with lactose drink and their intolerance was assessed serially by H2 breath test.

Results: Results of this study shows 31 (n-69), percent prevalence in children, who had Lactose intolerance in-group of 220 school children.  In this study the highest number of Lactose intolerance (LI) was found in oldest age group that is more than eleven years and 33% in lowest age group (less than 8 years of age), but it does not show any gradual increase in number as the age increases. According to the WHO classification of Malnutrition, 27.3% of children in this group were stunted.  Stunted group had 42% intolerant and 58% tolerant. But when tolerant group (Negative HBT) was observed the difference in stunted and normal height group children was statistically significant (P-Value 0.034) This study also indicates that underweight children had more intolerance in comparison to normal weight children but this was not statistically significant (p value- 0.26)

Conclusion: Nutritional status appears to affect lactose absorption.

Applicability: This study showed a high prevalence of lactose intolerance in Pakistan and calls for linking lactose intolerance to under-nutrition too.

Key words:  Lactose intolerance,   Malnutrition,   Hydrogen Breath Test