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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.
Bifidobacterium longum BB536 alleviated upper respiratory illnesses and modulated gut microbiota profiles in Malaysian pre-school children

Lau AS, Yanagisawa N, Hor YY, Lew LC, Ong JS, Chuah LO, et al.

Benef Microbes, 2018 Jan 29;9(1):61-70.
PMID: 29065707 DOI: 10.3920/BM2017.0063

This 10-months randomised, double-blind, parallel and placebo-controlled study evaluated the effects of Bifidobacterium longum BB536 on diarrhoea and/or upper respiratory illnesses in 520 healthy Malaysian pre-school children aged 2-6 years old. The subjects randomly received a one-gram sachet containing either BB536 (5×109 cfu) or placebo daily. Data analysis was performed on 219 subjects who fully complied over 10-months (placebo n=110, BB536 n=109). While BB536 did not exert significant effects against diarrhoea in children, Poisson regression with generalised estimating equations model indicated significant intergroup difference in the mean number of times of respiratory illnesses over 10 months. The duration of sore throat was reduced by 46% (P=0.018), with marginal reduction for duration of fever (reduced by 27%, P=0.084), runny nose (reduced by 15%, P=0.087) and cough (reduced by 16%, P=0.087) as compared to the placebo. Principal coordinate analysis at genus level of the gut microbiota revealed significant differences between 0 and 10 months in the BB536 group (P<0.01) but not in placebo group (P>0.05). The abundance of the genus Faecalibacterium which is associated with anti-inflammatory and immuno-modulatory properties was significantly higher in the BB536 group (P<0.05) compared to the placebo group. Altogether, our present study illustrated the potential protective effects of BB536 against upper respiratory illnesses in pre-school Malaysian children, with gut microbiota modulating properties.

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