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Nutritional status and diarrhoeal morbidity: a longitudinal study in rural Indian preschool children
Insights
Malnutrition in preschool children does not increase diarrhea incidence but significantly worsens its severity. Grade III malnutrition led to more severe dehydration and higher ETEC isolation in children.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Malnutrition and diarrhoeal diseases are critical, interconnected health issues affecting preschool children in developing nations.
- Understanding the relationship between nutritional status and diarrhoeal morbidity is crucial for targeted interventions.
Purpose of the Study:
- To prospectively investigate the impact of malnutrition on diarrhoeal morbidity in preschool children.
- To determine if pre-existing malnutrition influences the incidence and severity of diarrhea.
Main Methods:
- A prospective study involving 721 children under five years old in two villages near Hyderabad.
- Children were categorized by nutritional grade based on initial anthropometric measurements.
- Diarrhoeal episodes and aetiology were monitored over one year; a subsample underwent etiological investigation.
Main Results:
- The incidence of diarrhea was approximately 1.6 episodes per child per year, consistent across all nutritional grades.
- Children with Grade III malnutrition experienced a significantly higher percentage of episodes leading to severe dehydration (P < 0.05).
- Enterotoxigenic Escherichia coli (ETEC) isolation was more frequent in children with Grade III malnutrition, suggesting increased gut bacterial load.
Conclusions:
- Pre-existing malnutrition does not significantly alter the incidence of diarrhea in preschool children.
- However, malnutrition, particularly Grade III, substantially increases the severity of diarrhoeal episodes, evidenced by higher rates of severe dehydration.
- These findings highlight the critical role of nutritional status in modulating the clinical outcome of diarrhoeal diseases.
Abstract:
Malnutrition and diarrhoeal diseases are important interrelated health problems of preschool children in the developing countries. For a prospective study to determine the effect of malnutrition on diarrhoeal morbidity 721 children under 5 years, living in two villages near Hyderabad were registered. The children were classified into different nutritional grades based on initial body weights and heights; and diarrhoea morbidity was recorded during the subsequent one year. The aetiology of diarrhoea was determined in a subsample. The incidence of diarrhoea was observed to be about 1.6 episodes/child/year and was similar in children with different nutritional grades. The percentage of episodes leading to severe dehydration was, however, significantly higher (P less than 0.05) in children with grade III malnutrition. The isolation of ETEC was also higher in this group indicating a greater bacterial load in the gut. Although pre-existing malnutrition did not affect the incidence of diarrhoea it seems to have a significant impact on the severity of the disease.