2025: BMJ Paediatrics: The Gambia Children Study
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BMJ Paediatrics Open · 2025
Randomised Feasibility Study of an Intestinal Adsorbent in Acute Diarrhoea in The Gambia
Prof. Stephen Allen · Dr Paul Rahden · BMJ Paediatrics Open · 2025
Full citation
Randomised feasibility study of an intestinal adsorbent in acute diarrhoea in The Gambia.
Rahden P, Allen S et al. BMJ Paediatrics Open 2025. Edward Francis Small Teaching Hospital, Banjul, The Gambia · Liverpool School of Tropical Medicine, Liverpool, UK · Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Why this study matters
Diarrhoea remains one of the leading causes of child mortality worldwide
Acute diarrhoea continues to be one of the leading causes of death in children under five years old globally — particularly in low and middle income countries where access to healthcare is limited and dehydration can rapidly become life-threatening. Finding safe, effective, and practical treatments that can be administered from the very first day of illness is a global health priority.
This randomised feasibility trial, conducted at the Edward Francis Small Teaching Hospital in Banjul, The Gambia, and published in BMJ Paediatrics Open in 2025, investigated whether Enterosgel® — mixed directly into oral rehydration solution — could reduce the duration of acute diarrhoea in young children presenting to emergency and outpatient paediatric services.
Study design
How the trial was conducted
50 children aged 6–59 months presenting with acute diarrhoea and no or some dehydration were enrolled at the emergency paediatric unit and outpatient clinic of Edward Francis Small Teaching Hospital, Banjul, The Gambia. They were randomised to either standard treatment or standard treatment with Enterosgel®.
Trial design at a glance
0–4 hours — double-blind
Initial blinded assessment phase on presentation to hospital.
Up to 5 days — open-label
Extended treatment phase for up to 5 days.
Standard treatment (oral rehydration fluid and zinc) plus Enterosgel® mixed directly into the oral rehydration solution.
Standard treatment alone (oral rehydration fluid and zinc).
Emergency paediatric unit and outpatient clinic, Edward Francis Small Teaching Hospital, Banjul, The Gambia.
Conclusion
A potentially life-saving finding for children worldwide
The study demonstrated that Enterosgel® can be mixed directly into oral rehydration solution and significantly reduces the duration of diarrhoea in children under 5 years old. Enterosgel® was safe, easy to take, and well tolerated by children throughout the trial.
The ability to mix Enterosgel® directly into oral rehydration solution is a particularly significant finding for low-resource settings — it means no additional equipment, no additional administration steps, and no barrier to compliance for young children and caregivers. Starting treatment from the first day of diarrhoea could be life-saving in populations where rapid deterioration is a real and present risk.
“Enterosgel® can be mixed directly into oral rehydration solution and significantly reduces the duration of diarrhoea in children under 5 years old. The use of Enterosgel® from the first day of diarrhoea can be life saving, as diarrhoea continues to be one of the leading causes of children’s death worldwide.”
Prof. Stephen Allen — Department of Clinical Sciences, Liverpool School of Tropical Medicine
The investigators
About the research team
Authors — BMJ Paediatrics Open 2025
Prof. Stephen Allen
Department of Paediatrics, Edward Francis Small Teaching Hospital, Banjul, Gambia. Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Dr Paul Rahden
Department of Paediatrics, Edward Francis Small Teaching Hospital, Banjul, Gambia. Department of Implementation Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Read the full clinical evidence for Enterosgel®
Including all published clinical trials, NHS Drug Tariff listing, and resources for healthcare professionals and patients.
View the research →References
- Rahden P, Allen S et al. Randomised feasibility study of an intestinal adsorbent in acute diarrhoea in The Gambia. BMJ Paediatrics Open 2025.
- Arasaradnam R, Pandya P, Howell C et al. Enterosgel for the treatment of adults with acute diarrhoea in a primary care setting: a randomised controlled trial. BMJ Open Gastroenterology 2019.
- Howell CA et al. Double-blinded randomised placebo controlled trial of enterosgel for the treatment of IBS with diarrhoea (IBS-D). Gut 2022;71:2430–2438. doi:10.1136/gutjnl-2022-327293