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Persistent diarrhea: risk factors and outcome.
B Umamaheswari1, Niranjan Biswal, B Adhisivam
1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Indian Journal of Pediatrics
|August 28, 2010
Summary
Antibiotic use, vitamin A deficiency, malnutrition, and lower respiratory infection (LRI) are key risk factors for persistent diarrhea (PD) in children. Identifying these factors can help reduce mortality from this condition.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutritional Science
Background:
- Persistent diarrhea (PD) is a significant cause of childhood morbidity and mortality globally.
- Identifying specific risk factors is crucial for effective prevention and management strategies.
Purpose of the Study:
- To determine risk factors associated with persistent diarrhea (PD).
- To identify risk factors contributing to deaths caused by PD.
Main Methods:
- A prospective case-control study involving 60 children with PD and 60 with acute diarrhea (AD).
- Data collected through detailed history, examination, and investigations.
- Statistical analysis included univariate and multivariate logistic regression to calculate Odds Ratios.
Main Results:
- Univariate analysis identified antibiotic use, steroid use, anemia, vitamin A deficiency, malnutrition, LRI, UTI, oral candidiasis, and hyponatremia as significant risk factors for PD.
- Multivariate analysis revealed prior antibiotic use, vitamin A deficiency, malnutrition, and LRI as independent predictors of PD.
- Mortality risk factors included frequent stools (>10/day), severe malnutrition, oral candidiasis, hypoalbuminemia, and HIV positivity.
Conclusions:
- Clinicians should be aware of identified risk factors to implement timely interventions.
- Early recognition and management of these risk factors can potentially decrease mortality associated with persistent diarrhea.
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