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Changing trends in prevalence, morbidity, and lethality in persistent diarrhea of infancy during the last decade in

José Carlos Guerra-Godínez1, Alfredo Larrosa-Haro, Pedro Coello-Ramírez

  • 1Servicio de Gastroenterología, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.

Archives of Medical Research
|October 22, 2003
PubMed
Abstract

Insights

Persistent diarrhea (PD) prevalence in infants decreased, but lethality and mortality rates remained unchanged. Malnutrition is a persistent issue, with shifts in carbohydrate and protein intolerance mirroring developed countries, suggesting an epidemiologic transition.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Gastroenterology

Background:

  • Persistent diarrhea (PD) in infancy historically presents high morbidity and lethality.
  • Recent trends suggested a potential decrease in PD's prevalence, morbidity, and lethality.
  • Understanding these changes requires comparative analysis of PD management outcomes.

Purpose of the Study:

  • To compare the prevalence, lethality, and morbidity of infants and children with PD.
  • To analyze trends in PD outcomes over a decade in a pediatric referral hospital.
  • To identify associated factors and epidemiological shifts in PD.

Main Methods:

  • A comparative cross-sectional study analyzed 546 patients with PD across three periods: 1988-1991, 1993-1994, and 1997-1999.
  • Calculated prevalence of admissions, nutritional status, sepsis, specific intolerances, and lethality.
  • Employed Student t and chi2 tests for statistical analysis.

Main Results:

  • Prevalence of PD admissions decreased from 31.7% to 13.8%, while lethality and mortality rates remained constant.
  • Malnutrition showed high prevalence across all periods.
  • Carbohydrate intolerance decreased, but protein intolerance increased; pneumatosis intestinalis and bowel perforation rates were unchanged.

Conclusions:

  • The prevalence of PD may be diminishing, but lethality and mortality rates are unchanged.
  • Malnutrition remains a significant associated factor in PD.
  • Shifting intolerance patterns suggest an epidemiologic transition of PD in Mexico.

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