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Toddler's diarrhea: is it an under-recognized entity in developing countries?
Ujjal Poddar1, Jaya Agarwal, Surender Kumar Yachha
1Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Aim:
As there is no report of toddler's diarrhea (TD) from the developing world, we have analyzed our experience of 191 children (<5 years) with chronic diarrhea over 7 years.
Methods:
Clinical details, investigations and outcome were retrieved and recorded in a proforma. TD was ascribed in those who had normal growth and no evidence of malabsorption or enteric infections.
Results:
The etiology of chronic diarrhea was TD 16%, celiac disease (CD) 37%, cow's milk protein allergy (CMPA) 35% and others 12%. The mean age of 30 children with TD was 2.7 ± 1.2 years (22 boys). While comparing TD with CD and CMPA, weight z score (>-2.2) and hemoglobin (>10 or 10.9 g/dL for CD and CMPA, respectively) were independent variables to discriminate TD from CD and CMPA.
Conclusions:
TD is common in developing countries like India too. Anthropometry and hemoglobin can differentiate it from CD and CMPA.
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