[Diarrheal disease in hospitalized children - importance of the persistent diarrhea]

OBJECTIVE: In this paper we aim at analyzing the epidemiological and clinical patterns of children with age below 24 months who were hospitalized with diarrhoea in order to determine the prevalence of persistent diarrhoea (PD). PATIENTS AND METHODS: 300 children with diarrhoea were studied at the General Hospital of Pediatrics - IMIP in Recife, Northeast Brazil, considering the period from July 1993 to March 1994. It was a cross-sectional study. The socio-demographic, clinical and evolutive characteristics of the sample were described. A bidimensional analysis was used to compare the groups with acute and persistent diarrhoea (PD) episodes. The proportion of deaths due to persistent diarrhoea was compared to the proportion of those due to acute diarrhoea. RESULTS: The majority of the children was younger than one year of age and come from low income families living in poor environmental and social conditions. At admission it was observed that the incidence of early weaning was high (44.2%); 71.1% of the children were below the third percentile for weight as compared with the NCHS curve. During the course of PD 33.2% of the children were hospitalized. Dysentery was detected in 52% of the cases. 106 children among the 246 observed (43.1%) recovered before the 14th day, while in 140 children (56.9%) diarrhoea persisted for two more weeks. PD contributed to extend the course of hospitalization and was associated with a higher proportion of fatal cases (72.9%). CONCLUSIONS: The majority of the children was younger than one year of age and come from low income families living in poor environmental and social conditions. PD frequency among the children who were hospitalized was high and accounted for a very high proportion of fatal cases. Inadequate management in the acute phase of diarrhoea was associated with the lengthening of the disease.