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Fulltext Development, translation and validation of questionnaires for diarrhoea and respiratoryrelated illnesses during probiotic administration in children

Lau, Amy Sie-Yik, Choi, Sy-Bing, Liong, Min-Tze, Muhamad Saiful Bahri Yusof, Lee, Yeong-Yeh, Faridah Rashid, et al.

Education in Medicine Journal, 2017;9(4):19-30.
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Background: Gastrointestinal illnesses and respiratory-related illnesses are common among
young children in Malaysia, especially those who are attending day care. During administration of
probiotic, the occurences of gastrointestinal and respiratory-related illnesses can be reduced. These
were observed by evaluation through a single questionnaire. However, currently no single tool exists
to simultaneously evaluate the domains of gastrointestinal and respiratory-related illnesses among
these young children. The current study aimed to develop a source questionnaire in English, translate
and validate into the Malay. Methods: Relevant domains of gastrointestinal and respiratory-related
illnesses were identified to generate items and formed a screening tool through literature reviews,
focus groups and opinions of experts. Results: The developed Basic Demographic and Lifestyle
Questionnaire (BDLQ) and Monthly Healthy Questionnaires (MHQ) showed item-level content
validity index (I-CVI) of 0.99 and 0.97, respectively, while the translated Malay versions showed I-CVI
of 1.00 and 0.99, respectively. Item-level face validity index (I-FVI) of 1.00 for both questionnaires
were obtained from 30 respondents showing that the items were clear and comprehensible.
Conclusion: This study showed good level of I-CVI and I-FVI in both developed questionnaires and
their Malay translated versions. These tools in English and Malay were valid and thus reliable to be
used for assessing gastrointestinal and respiratory-related illnesses in young children.
Development and validation of a Chinese translated questionnaire: A single simultaneous tool for assessing gastrointestinal and upper respiratory tract related illnesses in pre-school children

Lau ASY, Yusoff MSB, Lee YY, Choi SB, Xiao JZ, Liong MT

J Taibah Univ Med Sci, 2018 Apr;13(2):135-141.
PMID: 31435316 DOI: 10.1016/j.jtumed.2017.11.003

Objectives: Children are prone to contagious illnesses that come from peers in nurseries, kindergartens, and day care centres. The administration of probiotics has been reported to decrease the episodes of such illnesses, leading to decreased absences and consumption of antibiotics. With less emphasis on, and preferences for, blood collection from young subjects, quantifiable data are merely obtained from surveys and questionnaires. Malaysia has a population which is 25% ethnic Chinese. We aimed to develop a single tool that enables simultaneous assessments of both gastrointestinal and respiratory tract-related illnesses among young Chinese children.
Methods: The English-language validated questionnaires using data about demographics and monthly health records were translated into the Chinese language. Both forward and backward translated versions were validated.
Results: The developed demographic and monthly health questionnaires showed an overall item-level content validity index (I-CVI) of 0.99 and 0.97, respectively; while the translated Chinese versions showed I-CVI of 0.97 and 0.98, respectively. Item-level of response process validity index of 1.00 for this questionnaire was obtained from 30 respondents inferring that the items were clear and comprehensible.
Conclusions: This study showed acceptable levels validity in the Chinese translated version, illustrating a valid and reliable tool to be used for simultaneous assessment of gastrointestinal and respiratory tract-related illnesses in young children that is applicable for Malaysia's Chinese population and other Chinese-speaking nations.
El Niño Altered Gut Microbiota of Children: A New Insight on Weather-Gut Interactions and Protective Effects of Probiotic

Lau ASY, Mitsuyama E, Odamaki T, Xiao JZ, Liong MT

J Med Food, 2019 Mar;22(3):230-240.
PMID: 30183458 DOI: 10.1089/jmf.2018.4276

Changes in weather often trigger a myriad of negative impacts on the environment, which eventually affect human health. During the early months of 2016, Malaysia experienced El Niño, with an extremely dry season of almost zero rainfall. At the same time, an increase of more than twofold in fecal secretary immunoglobulin-A (SIgA) levels of healthy preschool children aged 2-6 years was observed, accompanied by an increase in phylum Bacteroidetes, predominantly attributed to genus Bacteroides and Odoribacter, which also positively correlated with fecal SIgA levels. Here, we present evidence to illustrate the detrimental effects of weather change on a microscopic "environment," the human gut ecosystem. We also discuss the protective effects of probiotic against dysbiosis as induced by weather change. The increase in Bacteroidetes was at an expense of decreased genus Faecalibacterium and Veillonella (phylum Firmicutes), whereas children consuming probiotic had a decrease in genus Collinsella, Atopobium, and Eggerthella (phylum Actinobacteria) instead.

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