The Study of Drug Metabolism G In Children with Protein Energy, Malnutrition and Tuberculosis Using 'The caffeine Breath Test

Abstract

The purpose of this study was to determine the applicability of the ,saffeine breath test in assessing liver drug metabolism. , in children/with Kwashiorkor and those on anti-TB drugs. Seventeen children aged between 3-10 years were recruited into the study, of which 8 were cases of kwashiorkor and 9 on anti-TB treatment. Both groups were studied before commencing dietary rehabilitation or anti- TB treatment. Labelled caffeine was given orally at a dose of 3 mg kg -1 dissolved in distilled water. Breath samples were collected by requesting the child to blow into the mask at intervals of 15 minutes for a period of 2 hours. The collected sample were transferred into a labelled headspace analyzer vial for storage pending analysis. The procedure was repeated after 10-14 days of intervention. Breath samples were analyzed at the Scottish Universities Research Reactor Centre, Edinburgh. Unfortunately, due to faulty seal on some of the collection vials, only a limited number of specimens had adequate amount of isotope for analysis (~50). In the kwashiorkor group there were 4 sin{ille and 3 duplicate samples which had adequate amount of isotope labelled carbon dioxide for analysis. In the patients with duplicate samples a rise in level of labelled carbon dioxide recovered after nutritional rehabilitation, 'the mean (SO) percentage was 2.86 (1.3) before and 3.6 vii (1.39) after rehabilitation. In TB patients there were 3 single and 4 duplicate samples which had adequate amount of isotope labelled carbon dioxide for analysis. In these TB patients with duplicate samples, two had a notable rise and the other two had marginal decline in level of cumulative labelled carbon dioxide after commencement of treatment. The study showed that the caffeine breath test is a useful test of liver drug metabolizing enzymes in children with malnutrition. The study also demonstrates that the caffeine breath test can be used in children of three years of age or possibly younger. Further studies are required particularly to repeat the test when the children have recovered from malnutrition and tuberculosis.