Persistent diarrhoea in the community. Characteristics and risk factors

In 58 previously well-nourished patients who were fed cow's milk and who later developed persistent diarrhoea (greater than or equal to 15 days), data obtained during the first 8 days of acute diarrhoea were compared with those of patients whose episodes lasted less than or equal to 8 days. Children with persistent diarrhoea weighted less at birth, passed greater than or equal to 6 stools/day during the first 48 hours, received early treatment with antibiotics. Their milk feedings were stopped during the first 48 hours, they had a past history of digestive diseases and hospitalizations, they were brought in for consultation after 5 days of symptoms and their nutritional status deteriorated more (p less than 0.003, p less than 0.03, p less than 0.0001, p less than 0.0001, p less than 0.0001, p less than 0.002, p less than 0.0001, and p less than 0.03, respectively). Their mothers were significantly younger (p less than 0.0013), had better schooling (p less than 0.037), and fewer children (p less than 0.044), and were separated from the index child during the day more often (p less than 0.056). After persistent diarrhoea was diagnosed, enteropathogens in stools or lactose intolerance or both were demonstrated in 75.9%. Treatment induced remission in all cases. Using logistic regression a predictive model was established which enables us to identify, among patients with acute diarrhoea, those at risk of prolonging their illness.