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Changing trend of persistent diarrhoea in young children over two decades: observations from a large diarrhoeal disease hospital in Bangladesh.

Abstract

AIM
  We studied the changing trend and factors associated with persistent diarrhoea (PD) in under-five children presenting to a large diarrhoeal disease hospital in urban Dhaka, Bangladesh, over the last two decades.
METHODS
  We used an unmatched case-control design, with a case (persistent diarrhoea; n=944) to control (acute diarrhoea; n=2832) ratio of 1:3 attending the Dhaka Hospital of icddr,b between 1991 and 2010.
RESULTS
  The proportion of children with PD decreased significantly from 8% in 1991 to 1% in 2010. The proportion of breastfeeding practices, measles vaccination coverage and vitamin A supplementation among 12-59 months old improved from 79% to 85%, 69% to 85% and 26% to 74%, respectively, which were significant. Although the isolation of rotavirus from stool in children with PD and acute diarrhoea increased, the isolation of Shigella spp., and Vibrio cholerae O1 decreased significantly. In a logistic regression analysis, wasting (OR=1.62), use of antibiotic before attending hospital (OR=5.94), absent clinical dehydration (OR=1.53) and bloody/mucoid stool (OR=3.33) were significantly associated with persistent diarrhoea.
CONCLUSION
  There, thus, is a need to integrate an appropriate and sustainable deterrent strategy to take the benefit of the significant reduction in prevalence as well as risks of PD in such population.

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  • Publisher Full Text

    • Authors

    Das SK, Faruque AS, Chisti MJ, Malek MA, Salam MA, Sack DA

    Institution

    International Centre for Diarrheal Disease Research, Bangladesh Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

    Source

    Acta paediatrica (Oslo, Norway : 1992) 101:10 2012 Oct pg e452-7

    MeSH

    Anti-Infective Agents
    Bangladesh
    Breast Feeding
    Case-Control Studies
    Child, Preschool
    Diarrhea
    Feces
    Female
    Humans
    Infant
    Interviews as Topic
    Logistic Models
    Male
    Measles Vaccine
    Prevalence
    Risk Assessment
    Rotavirus
    Shigella
    Thinness
    Vibrio cholerae O1
    Vitamin A

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22734659