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Mortality associated with acute watery diarrhea, dysentery and persistent diarrhea in rural North India

N Bhandari, M K Bhan, S Sazawal

    Acta Paediatrica
    |September 1, 1992
    PubMed

    Insights

    Diarrhea deaths in young children in North India were linked to dysentery and persistent diarrhea. Malnutrition significantly increased mortality risk, highlighting its role in fatal diarrhea cases.

    Area of Science:

    • Pediatrics
    • Infectious Diseases
    • Public Health

    Background:

    • Diarrheal diseases remain a leading cause of mortality in young children globally.
    • Understanding specific diarrhea types and associated factors is crucial for effective intervention.

    Purpose of the Study:

    • To investigate mortality associated with different types of diarrhea in children under 6 years in rural North India.
    • To identify risk factors, including malnutrition, contributing to diarrhea-related deaths.

    Main Methods:

    • Longitudinal cohort study of 1467 children under 6 years in rural North India.
    • Recorded 1663 diarrhea episodes and 23 diarrhea-related deaths over 20 months.
    • Analyzed case fatality rates by diarrhea type, duration, and nutritional status.

    Main Results:

    • Case fatality rates varied significantly: acute watery diarrhea (0.56%), dysentery (4.27%), and persistent diarrhea (11.94%).
    • Persistent diarrhea, especially dysenteric, had higher mortality (21.1%).
    • Malnutrition drastically increased risk; severe malnutrition cases had 24 times higher fatality (7.48%) than normally nourished children (0.31%).

    Conclusions:

    • Dysentery and persistent diarrhea are major contributors to diarrhea mortality in this setting, particularly with the use of oral rehydration therapy.
    • Underlying malnutrition is a critical factor exacerbating diarrhea-related mortality in children.
    • Targeted interventions for persistent diarrhea, dysentery, and malnutrition are essential to reduce child mortality.

    Keywords:
    AsiaChild MortalityChild NutritionCohort AnalysisDemographic FactorsDeveloping CountriesDiarrheaDiarrhea, InfantileDiseasesHealthIncidenceIndiaInfant MortalityLongitudinal StudiesMalnutritionMeasurementMortalityNutritionNutrition DisordersOral RehydrationPopulationPopulation CharacteristicsPopulation DynamicsResearch MethodologyRural PopulationSouthern AsiaStudiesTreatment

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