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Update on prolonged and persistent diarrhea in children
1Division of Gastroenterology, Hepatology, and Nutrition, Center for Global Child Health, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA. sean.moore@cchmc.org
Insights
Prolonged and persistent diarrhea in children significantly impacts global health and child development. Early zinc therapy and specialized diets can improve outcomes, but more research is needed for effective management in resource-limited settings.
Area of Science:
- Pediatric Gastroenterology
- Global Child Health
- Infectious Diseases
Background:
- Prolonged and persistent diarrhea episodes in children are less common than acute diarrhea but contribute significantly to the global burden of diarrheal diseases.
- These conditions are intricately linked to the cycle of childhood malnutrition, where undernutrition exacerbates diarrhea, and diarrhea worsens nutritional status.
Purpose of the Study:
- To review recent advancements in understanding prolonged and persistent diarrhea in children.
- To examine the global health impact, effects on child development, epidemiological links, and management strategies for these conditions.
Main Methods:
- Literature review focusing on recent scientific publications and global health data.
- Analysis of epidemiological links and the impact on childhood growth and development.
- Evaluation of current and novel prevention and management strategies.
Main Results:
- Prolonged and persistent diarrhea represent a substantial global health challenge, contributing to childhood morbidity and mortality.
- Zinc therapy, as recommended by the World Health Organization (WHO), is crucial for reducing illness and death in children with diarrhea, especially in developing countries.
- Nutritional interventions, such as yogurt-based or amino acid-based diets, show promise in accelerating recovery for children experiencing persistent diarrhea.
Conclusions:
- Implementing established acute diarrhea prevention and management strategies is essential.
- Further research is critically needed to improve the recognition, prevention, and treatment of prolonged and persistent diarrhea in resource-limited settings.
- Addressing these diarrheal episodes is vital for breaking the cycle of malnutrition and improving child survival and development globally.
Purpose Of Review:
To highlight recent advances in our understanding of prolonged episodes of acute diarrhea and persistent diarrhea in children. The focus is on the contribution of these illnesses to the global burden of diarrhea, their impact on childhood growth and development, novel epidemiologic links between prolonged and persistent diarrheal episodes, and strategies for their prevention and management.
Recent Findings:
Although less common than acute diarrhea, prolonged and persistent episodes of diarrhea in childhood constitute a significant portion of the global burden of diarrhea. These episodes also play a key role in the vicious cycle of childhood diarrhea and malnutrition in which undernutrition is both a risk factor and an outcome of diarrhea. Increased efforts to provide WHO-recommended zinc therapy for all children with diarrhea in developing countries will significantly reduce morbidity and mortality. In children who develop persistent diarrhea, yogurt-based or amino acid-based diets may accelerate their recovery.
Summary:
In addition to increased implementation of strategies already known to effectively prevent and manage acute diarrhea, further research is needed to address the recognition, prevention, and treatment of prolonged episodes of acute diarrhea and persistent diarrhea in resource-limited settings.
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