Abstract
Objective
To identify risk factors associated with Persistent diarrhea (PD) and deaths due to PD.
Methods
This prospective case control study included 60 children with PD (cases) and 60 children (controls) with acute diarrhoea (AD). Detailed history, examination and appropriate investigations were done for all children. Crude Odds ratio was calculated for each risk factor by univariate analysis and adjusted odds ratio was calculated by multivariate logistic regression.
Results
Prior antibiotic use, steroid use, anemia, vitamin A deficiency, malnutrition, LRI, UTI, oral candidiasis, and hyponatremia, were statistically significant risk factors by univariate analysis. Prior antibiotic use, vitamin A deficiency, malnutrition and LRI were independently associated with PD by multivariate logistic regression analysis. The risk factors for mortality were stool frequency more than 10 times per day, severe malnutrition, oral candidiasis, hypoalbuminemia and HIV positivity.
Conclusions
The presence of these risk factors should alert the clinician to take appropriate measures, to decrease the mortality.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Fauveau V, Henry FJ, Briend A et al. Persistent diarrhoea as a cause of childhood mortality in rural Bangladesh. Acta Pediatr Suppl 1992; 381: 12–14.
Bhan MK, Arora NK, Ghai KR et al. Major factors in diarrhea related mortality among rural children. Ind J Med Res 1986; 83: 9–12.
World Health Organisation. Diarrhoeal disease control programme. Persistent diarrhoea in children in developing countries: Report of a WHO meeting. Geneva: WHO, 1988.14p. (WHO/CDD/88.27.1988).
Baqui AH, Black RE, Sack RB et al. Epidemiological and clinical characteristics of acute and persistent diarrhoea in rural Bangladeshi children. Acta Pediatr Suppl 1992; 381: 15–21.
Henry FJ, Udoy AS, Wanke CA, Aziz K. Epidemiology of persistent diarrhea and etiologic agents in Mirzapur, Bangladesh. Acta Pediatr Suppl 1992; 381: 27–31.
Alam NH, Faruque AS, Dewan N, Sarkar SA, Fuchs GJ. Characteristics of children hospitalised with severe dehydration and persistent diarrhoea in Bangladesh. J Health Popul Nutr 2001; 19: 18–24.
Ngan PK, Khanh NG, Tuong CV et al. Persistent diarrhoea in Vietnamese children: a preliminary report. Acta Pediatr Suppl 1992; 381: 124–126.
Mbori-Ngacha DA, Otieno JA, Njeru Ek, Onyango FE. Prevalence of persistent diarrhoea in children aged 3 — 36 months at the Kenyatta National Hospital, Nairobi, Kenya. East Afr Med J 1995; 72: 711–714.
Deivanayagam N, Mala N, Ashok TP, Ratnam SR, Sankaranarayanan VS. Risk factors for persistent diarrhoea among children under 2 years of age — Case control study. Ind Pediatr 1993; 30: 177–185.
Gernaat HBPE, Voorhoeve HWA. A new classification of acute protein energy malnutrition. J Trop Pediatr 2000; 46: 97–106.
Lo CW, Walker WA. Chronic protracted diarrhoea of infancy: a nutritional disease. Pediatr 1983; 72: 786–800.
Nigar SS, David AS, Maksudar R, Ahmed NA, Nurur R. Risk factors for persistent diarrhoea. Br Med J 1988; 297: 1036–1038.
Bhan MK, Bhandari N, Bhatnagar S et al. Epidemiology and management of persistent diarrhea in children of developing countries. Ind Med Res 1996; 104: 103–114.
Ahmed M, Biloo AG, Murtaza G. Risk factors of persistent diarrhea in children below five years of age. J Pak Med Assoc 1995; 45: 290–292.
Anupam S, Patwari AK, Anand BK, Chabra D, Chandra. Associated infections in persistent diarrhea —another perspective. J Trop Pediatr 1996; 42: 64–67.
Roy SK, Alam AN, Majid N et al. Persistent diarrhea; a preliminary report on clinical features and dietary therapy in Bangladeshi children. J Trop Pediatr 1989; 35: 55–59.
Sachdev HPS, Kumar S, Singh KK et al. Risk factors for fatal diarrhea in hospitalized children in India. J Ped Gastroenterol Nutr 1991; 12: 76–81.
Patwari AK, Anand VK, Aneja S, Sharma D. Persistent diarrhea: Management in Diarrhea treatment Unit. Ind Pediatr 1995; 32: 277–284.
Guinar U, Aynur S, Sadi V. Clinical risk factors for fatal diarrhea in hospitalized children. Ind J Pediatr 2000; 67: 329–336.
Zulfiqar AB, Nizami SQ, Thobani S et al. Risk factors for mortality among hospitalized children in Pakistan. J Trop Pediatr 1997; 43: 330–336.
Keush GT et al. Persistent diarrhea associated with AIDS. Acta Pediatr suppl 1992; 381: 45–48.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Umamaheswari, B., Biswal, N., Adhisivam, B. et al. Persistent diarrhea: Risk factors and outcome. Indian J Pediatr 77, 885–888 (2010). https://doi.org/10.1007/s12098-010-0125-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-010-0125-y