Relative Efficacy of Probiotics Compared with Oral Rehydration Solution for Diarrhea Treatment in Children under Five Years Old: a Meta-Analysis from Developing Countries

Background: Children under five experience an average of three episodes of diarrhea each year in developing countries. Based on World Health Organization (WHO) guidelines, therapy for acute diarrhea is oral rehydration fluid and zinc to treat fluid and electrolyte loss. But unfortunately, this therapy does not reduce the duration of diarrhea without the intestinal barrier function of pathogenic microorganisms. The ability to inhibit pathogens is one of the three main mechanisms of probiotics. This study aims to examine the efficacy of using probiotics compared to oral rehydration solution (ORS) in the treatment of acute diarrhea in children under five in developing countries.Subjects and Method: This study is a meta-analysis conducted using PRISMA systematic guidelines. The process of searching for articles was carried out between 2009 and 2019 using a database search engine consisting of PubMed, British Medical Journal (BMJ), CAB Direct, Oxford Academy, Clinical Key, ScienceDirect, and Scopus. Based on a database search, six articles that meet the criteria of the Randomized Controlled Trial (RCT) and research conducted in developing countries were found. The study involved 1234 children who were divided into two groups: 762 probiotic groups and 472 ORS groups. The analysis was performed with the Review Manager (RevMan) software 5.3. The results were assessed using Standardized Mean Difference (SMD).Results: There was heterogeneity between experiments (I2 = 91%; p <0.001) so Random Effects Model (REM) was used. Probiotics could reduce the duration of acute diarrhea in infants rather than just ORS, with a pooled estimate of 1.13 (SMD = -1.13; 95% CI = -1.54 to -0.72; p