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Children at risk of developing dehydration from diarrhoea: a case-control study
Farid Uddin Ahmed1, Enamul Karim
1Comilla Medical College/Hospital, Bangladesh.
Insights
Vomiting, lack of home oral rehydration therapy, maternal hygiene, and distance from healthcare facilities are key predictors of dehydration in Bangladeshi children with diarrhea. These factors help identify at-risk infants for targeted interventions.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Diarrhea remains a leading cause of dehydration in young children globally.
- Identifying specific risk factors for dehydration is crucial for effective prevention and management.
Purpose of the Study:
- To pinpoint factors associated with dehydration in Bangladeshi children under two years old presenting with diarrhea.
- To develop a predictive model for identifying children at high risk of developing diarrhea-associated dehydration.
Main Methods:
- A hospital-based case-control study involving 80 cases with dehydration and 160 age-matched controls without dehydration.
- Data collection included clinical examination and maternal interviews, with a 14-day follow-up.
- Statistical analysis employed bivariate analysis and stepwise logistic regression to identify significant prognostic factors.
Main Results:
- Seventeen of thirty-eight studied factors were significantly associated with dehydration development.
- A combination of vomiting, inadequate home oral rehydration therapy, poor maternal hygiene (dirty fingernails), and long distance (>3 km) to the hospital showed high predictive accuracy (77.5% sensitivity, 91.2% specificity).
Conclusions:
- Vomiting, lack of home oral rehydration therapy, maternal hygiene, and distance from healthcare facilities are significant predictors of diarrhea-associated dehydration in young children.
- These identified prognostic factors can empower community health workers to recognize high-risk children and implement targeted preventive strategies.
Abstract:
To identify the factors related to dehydration from diarrhoea, a hospital-based case-control study was carried out among under-2-year-old Bangladeshi children. The study compared 80 cases who had 'some' or severe dehydration with 160 age-matched controls who had 'no signs' of dehydration. All the cases and controls were examined and the mothers were interviewed in the hospital and followed at home on the 14th day of illness. Thirty-eight factors were studied for their probable influence on the development of dehydration. In bivariate analysis, 17 factors were found to be associated significantly with the development of dehydration and were treated with stepwise logistic regression analysis. A combination of vomiting, oral rehydration therapy at home, mother's dirty finger nails, and residing more than 3 km away from the hospital provided the maximum sensitivity (77.5 per cent) and specificity (91.2 per cent) for predicting development of dehydration. These prognostic factors would be helpful for community health workers to identify children at risk of developing diarrhoea-associated dehydration, and preventive strategies could be designed to alter the prognostic factors.