A NARRATIVE REVIEW ON THE PROTECTIVE MECHANISM OF PROBIOTICS TO COMMUNICABLE DISEASES AMONG CHILDREN IN ASIA
DOI:
https://doi.org/10.63953/jisn.v3i4.66Keywords:
Probiotics, Children, Communicable Diseases, Gut microbiota, Nutrition, Southeast AsiaAbstract
Background: Communicable diseases remain a major cause of morbidity among children in Southeast Asia, where malnutrition, environmental enteric dysfunction, and limited sanitation increase susceptibility to infection. Probiotics have gained attention as a nutrition-based strategy capable of improving gut health, enhancing immunity, and reducing pathogen burden. This narrative review summarizes the protective mechanisms of probiotics and their relevance for child health in Indonesia and neighboring countries. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Google Scholar for studies published from January 2004 to February 2025. Search terms included “probiotics,” “children,” “communicable diseases,” “gut microbiota,” “malnutrition,” and “synbiotics.” Inclusion criteria were: pediatric populations (0–18 years), probiotic interventions, and outcomes related to infection, intestinal integrity, immune function, or nutritional status. Fourteen core studies (RCTs, systematic reviews, meta-analyses, and narrative reviews) met criteria, and five additional sources were used for epidemiological and conceptual background. Results: Evidence across Indonesia, Vietnam, Malaysia, China, India, and Thailand shows that probiotics improve gut microbiota diversity, reduce pathogenic colonization, strengthen tight-junction expression, and enhance mucosal immunity. Clinical benefits include reduced incidence and duration of diarrhea and respiratory infections, improved recovery reflected in increased appetite and weight gain, reduced antibiotic prescriptions, and decreased school absenteeism. Probiotics were feasibly delivered through fortified milk, yogurt, supplements, and school-based nutrition platforms, aligning well with existing child-health programs. Conclusion: Probiotics offer a safe, nutrition-focused intervention that helps mitigate the infection–malnutrition cycle in children. By supporting gut integrity and immune maturation, probiotics complement established nutrition strategies. Integrating probiotics into routine child nutrition and infectious-disease prevention programs may provide meaningful public health benefits, though long-term and multi-strain studies are needed to guide scalable implementation.
References
Kementerian Kesehatan RI. Laporan Nasional Riskesdas 2018. Jakarta: Balitbangkes; 2019.
Ministry of Health Indonesia. Profil Kesehatan Indonesia 2021. Jakarta: Kemenkes RI; 2022.
Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century. Lancet. 2016;387:475–90. DOI:10.1016/S0140-6736(15)01024-7.
Nakayama J, Yamamoto A, Shimakawa M, Yuki N, Ida M, Shimojo N. Impact of diet and lifestyle on gut microbiota in Asia. Gut Microbes. 2021;13(1):186–201. DOI:10.1080/19490976.2020.1814852.
Sari LN, Widodo I, Nasar SS. Effect of Lactobacillus reuteri on diarrhea in Indonesian toddlers. Paediatr Indones.2019;59(3):156–63.
Nguyen KV, Tam DTM, Pham HV, Pham KT, Nguyen TH, Le NP. Probiotics reduce respiratory infections in Vietnamese children. J Pediatr Infect Dis. 2016;11:81–7.
Chatchatee P, Lee WS, Carrion J, et al. Probiotic milk for preventing infections in Thai preschool children. Asia Pac J Clin Nutr. 2014;23(2):226–33.
Abdul Rahim N, Ahmad A, Yu C, Ismail R, Hashim H, Jalaludin MY, et al. Probiotic-fermented milk reduces URTI in Malaysian children. Nutrients. 2020;12(10):3050. DOI:10.3390/nu12103050.
Kementerian Kesehatan RI. Status Gizi Balita. Infodatin Gizi; 2021.
Nurhayati E, Khomsan A, Atmarita A, Riyadi H. Dietary diversity and microbiota in Indonesian children. J Gizi Klin Indones. 2020;17(2):65–73.
Firmansyah A, Suparman M, Budiono W, et al. Lactobacillus casei Shirota reduces gastrointestinal infections in Indonesian schoolchildren. Southeast Asian J Trop Med Public Health. 2012;43:19–25.
Kashyap PC, Shergill-Bonner R, Baishya N, et al. Lactobacillus plantarum reduces diarrhea in Indian children. Indian Pediatr. 2018;55:681–6.
Li X, Song P, Li H, Jiang S, Yu Y, Wang L. Bifidobacterium lactis HN019 improves gut microbiota in Chinese children. Benef Microbes. 2019;10(2):167–77. DOI:10.3920/BM2018.0130.
Brown EM, Wlodarska M, Willing BP. Diet and the intestinal microbiota: an introduction. J Clin Gastroenterol.2017;51 Suppl 1:S3–6.
Smith MI, Yatsunenko T, Manary MJ, Trehan I, Mkakosya R, Cheng J, et al. Gut microbiomes of Malawian twin pairs discordant for kwashiorkor. Science. 2013;339:548–54. DOI:10.1126/science.1229000.
Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016;(12):CD005436. DOI:10.1002/14651858.CD005436.pub3.
Stefanová I, Jancíková B, Prokešová M. Vitamin A deficiency: immune and gut barrier consequences. Nutrients.2020;12(3):674. DOI:10.3390/nu12030674.
Anderson RC, Cookson AL, McNabb WC, Park Z, McCann MJ, Kelly WJ. Lactobacillus plantarum MB452 enhances tight junction protein expression. APMIS. 2010;118:269–78. DOI:10.1111/j.1600-0463.2009.02596.x
Patel RM, Denning PW. Therapeutic use of prebiotics, probiotics, and postbiotics to prevent necrotizing enterocolitis. Clin Perinatol. 2013;40:11–25. DOI:10.1016/j.clp.2012.12.008.
Wang Y, Wang B, Wu J, Jiang X, Tang H, Sang L. Probiotics modulate gut epithelial cell function. Nutr Res.2019;68:1–16. DOI:10.1016/j.nutres.2019.05.003.
Puertollano E, Kolida S, Yaqoob P. Short-chain fatty acids: biological significance. Br J Nutr. 2014;111(S1):S1–7. DOI:10.1017/S0007114513003210.
Phavichitr N, Lertpienthum N, Sangsupawanich P, Ongchavalit P, Chatwong K, Muangchana C. Lactobacillus rhamnosus GG improves gut permeability in Thai children. J Med Assoc Thai. 2015;98(Suppl 6):S71–6.
Suparyanto T, Adrial F, Lestari R. Probiotic yogurt improves gut integrity in malnourished Indonesian toddlers. J Kedokt Indones. 2017;5(1):45–53.
Chong SY, Ahmad K, Arumugam V, Tian FM, Chai LC, Abdul Mutalib NA. Lactobacillus casei Shirota improves IgA in Malaysian children. J Funct Foods. 2019;52:15–23. DOI:10.1016/j.jff.2018.11.020.
Shida K, Sato S, Imai S, et al. Probiotic Lactobacillus gasseri and Bifidobacterium longum reduce infections in Japanese children. J Nutr Sci Vitaminol. 2015;61(1):40–6.
Zimmermann P, Curtis N. Influence of probiotics on vaccine responses. Vaccine. 2017;36(2):207–13. DOI:10.1016/j.vaccine.2017.11.018.
Tavares-Silva M, Siqueira JF, Filho VJ, Santos M, Lacerda D, Vieira R. Probiotics and immune response to vaccination in infants. Pediatr Res. 2011;70(4):409–15. DOI:10.1203/PDR.0b013e31822bfa41.
Tun HM, Zhang L, Li S, Chen R, Wang X, Zhang S, et al. Gut microbiota correlates with antibody responses to SARS-CoV-2 vaccines. J Transl Med. 2024;22:827. DOI:10.1186/s12967-024-05637-2.
Jung JY, Lee SH, Park MS, Lim H, Kim JH. SCFA-producing probiotics reduce inflammation in Korean children. Clin Nutr. 2018;37:2065–72. DOI:10.1016/j.clnu.2017.10.019.
Wang Y, Wang B, Wu J, Fu L, Dang L, Zhang T. Probiotics decrease inflammatory cytokines in Chinese children with recurrent infections. Pediatr Int. 2019;61:499–505. DOI:10.1111/ped.13837.
Arifiany NA, Le HT, Nguyen TV, Khan NC, Do TT, Dung NK, et al. Efficacy of probiotics on digestive disorders and respiratory infections in Vietnamese children. Eur J Clin Nutr. 2024;78(5):789–97. (DOI pending)
Truong TM, Pham TT, Hoang HH, Trang TTT, Yui S, Shigehisa A, et al. Probiotics for digestive disorders and ARI in Vietnamese children. Eur J Clin Nutr. 2021;75:513–20. DOI:10.1038/s41430-020-00780-3.
Li Z, Zhu G, Li C, Lai H, Liu X, Zhang L. Which probiotic is the most effective for treating acute diarrhea in children? Nutrients. 2021;13:4319. DOI:10.3390/nu13124319.
Tamime AY, Saarela M, Sondergaard AK, Mistry VV, Shah NP. Probiotic Dairy Products. Oxford: Blackwell Publishing; 2005.
Lestari W, Simanjuntak Y, Sari I, Purnamasari D, Rahmawati E, Kartono D. School-based nutrition interventions in Indonesia. Asia Pac J Clin Nutr. 2021;30(4):743–52. DOI:10.6133/apjcn.202112_30(4).0018.
UNICEF, World Health Organization. WASH and Nutrition: Technical Brief. Geneva: WHO; 2019.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Saskia Piscesa, Tricahyani Endah Yuniarti, Elizabeth Anita Wijayanti
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
LICENSE TO PUBLISH
- All material published by the Journal of Indonesian Specialized Nutrition is protected under International copyright and intellectual property laws. Journal of Indonesian Specialized Nutrition is licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA) or an equivalent license as the optimal license for the publication, distribution, use, and reuse of scholarly works.
- This license permits anyone to compose, repair, and make derivative creations even for commercial purposes, as long as appropriate credit and proper acknowledgment of the original publication from a journal are made to allow users to trace back to the original manuscript and author.
- You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. If you remix, transform or build upon the material, you must distribute your contributions under the same license as the original.
