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Outcome of cases of persistent diarrhea after discharge
1Department of Pediatrics, Jawaharlal Nehru Medical College, AMU, Aligarh. seema_alam@hotmail.com
Insights
Children experiencing recurrent diarrhea after initial recovery may face risks from short hospital stays. Pediatricians should be cautious with female children due to higher relapse risks.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Persistent diarrhea in children can lead to recurrent episodes and associated complications post-recovery.
- Identifying risk factors for relapse is crucial for effective pediatric care and improved patient outcomes.
Purpose of the Study:
- To investigate and identify significant risk factors associated with the relapse of diarrhea in children after initial recovery.
- To inform clinical practice and public health strategies aimed at reducing childhood diarrhea recurrence.
Main Methods:
- A case-control study design was employed, comparing children with diarrhea relapse (failure group) to those without (non-failure group).
- Risk factors including duration of hospital stay, maternal employment, socioeconomic status, and sibling presence were analyzed.
- Univariate and logistic regression analyses were used to determine the statistical significance of identified risk factors.
Main Results:
- Univariate analysis indicated significant associations between diarrhea relapse and shorter hospital stays (< 5 days), working mothers, lower socioeconomic status, and younger siblings.
- Logistic regression analysis confirmed that hospital stay < 5 days (OR 11.7) and being female (OR 17.65) were independently significant predictors of relapse.
- Female children and those with shorter hospitalizations demonstrated a markedly higher risk of recurrent diarrheal episodes.
Conclusions:
- Short hospital stays and limited health education contact are significant risk factors for pediatric diarrhea relapse.
- Female gender is identified as a significant risk factor for recurrent diarrhea, necessitating focused clinical attention.
- Pediatricians should consider these factors to optimize management and reduce relapse rates in vulnerable pediatric populations.
Abstract:
After recovery from persistent diarrhea, some children have recurrent episodes of diarrhea and associated problems. We undertook this study to identify the risk factors responsible for this relapse. All patients reporting at 1 month follow up since discharge, with > 7 diarrheal days, or inadequate weight gain compared to the weight at discharge, constituted the failure group. All others constituted the non-failure group. Various risk factors were studied in 21 cases (failure group), and 42 controls (non-failure group). Univariate analysis revealed a significant association of hospital stay < 5 days (OR 10.6; 95% CI 3.13-36), working mothers (OR 8.5; 95% CI 2.5-27), poor socioeconomic status (OR 4.5; 95% CI 1.4-14) and presence of younger sibling (OR 3.69, 95% CI 1.1-12.6) with failed outcome. On logistic regression analysis, only hospital stay < 5 days (OR 11.7; 95% CI 1.02-134.68) and female children (OR 17.65; 95% CI 1.26-246) remained significant. We therefore conclude, that a short hospital stay, limited optimal contact and limited health education adversely affects the outcome. Pediatricians should be more cautious while managing female children.