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Risk factors for extended duration of acute diarrhea in young children
Tor A Strand1, Pushpa R Sharma, Håkon K Gjessing
1Centre for International Health, University of Bergen, Bergen, Norway. tors@me.com
Insights
Young children with frequent stools, not being breastfed, or getting diarrhea during the monsoon season face prolonged illness. Breastfeeding is a key factor in preventing extended diarrhea duration in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Global Health
Background:
- Diarrheal diseases cause significant mortality in young children globally.
- Understanding predictors of prolonged diarrhea is crucial for reducing child deaths.
Purpose of the Study:
- To identify risk factors associated with extended diarrhea duration in young children.
- To inform public health interventions aimed at reducing diarrheal disease burden.
Main Methods:
- Prospective follow-up of 391 diarrhea episodes in Nepalese children aged 6-35 months.
- Multiple logistic regression analysis to determine independent risk factors for diarrhea lasting over 7 days.
Main Results:
- Younger age (infants and toddlers) significantly increased the odds of prolonged diarrhea.
- Not being breastfed was strongly associated with extended illness duration.
- Increased stool frequency and diarrhea onset during the monsoon season were also identified as risk factors.
Conclusions:
- High stool frequency, lack of breastfeeding, young age, and monsoon season onset are key predictors of prolonged diarrhea.
- Breastfeeding emerges as a critical modifiable factor for preventing extended diarrhea in vulnerable populations.
Objective And Background:
We sought to identify predictors of extended duration of diarrhea in young children, which contributes substantially to the nearly 1 1/2 million annual diarrheal deaths globally.
Methods:
We followed 6-35 month old Nepalese children enrolled in the placebo-arm of a randomized controlled trial with 391 episodes of acute diarrhea from the day they were diagnosed until cessation of the episode. Using multiple logistic regression analysis, we identified independent risk factors for having diarrhea for more than 7 days after diagnosis.
Results:
Infants had a 17 (95% CI 3.5, 83)-fold and toddlers (12 to 23 month olds) a 9.9 (95% CI 2.1, 47)-fold higher odds of having such illness duration compared to the older children. Not being breastfed was associated with a 9.3 (95% CI 2.4, 35.7)-fold increase in the odds for this outcome. The odds also increased with increasing stool frequency. Furthermore, having diarrhea in the monsoon season also increased the risk of prolonged illness.
Conclusion:
We found that high stool frequency, not being breastfed, young age and acquiring diarrhea in the rainy season were risk factors for prolonged diarrhea. In populations such as ours, breastfeeding may be the most important modifiable risk factor for extended duration of diarrhea.
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