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Risk factors for development of dehydration in young children with acute watery diarrhoea: a case-control study
S K Bhattacharya1, M K Bhattacharya, B Manna
1Clinical Department, National Institute of Cholera and Enteric Diseases, Calcutta, India.
Insights
Stopping breastfeeding and not administering oral rehydration solution (ORS) during acute watery diarrhea significantly increase dehydration risk in children under two. These factors are crucial for diarrheal disease control programs.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Acute watery diarrhea is a leading cause of dehydration in children.
- Identifying risk factors is crucial for effective intervention strategies.
Purpose of the Study:
- To identify significant risk factors for life-threatening dehydration in children under two years old suffering from acute watery diarrhea.
Main Methods:
- A case-control study involving 379 children (243 cases, 136 controls) up to 2 years of age.
- Univariate and multivariate analyses were performed to identify risk factors and control for confounders.
Main Results:
- Multivariate analysis identified withdrawal of breastfeeding (OR=6.8) and not giving oral rehydration solution (ORS) (OR=2.1) as significant risk factors.
- Other significant contributing factors included young age, frequent purging, vomiting, and severe undernutrition.
Conclusions:
- Withdrawal of breastfeeding and withholding ORS during diarrhea are critical risk factors for severe dehydration.
- Findings can inform diarrheal disease control programs for prevention strategies.
Abstract:
In a case-control study to understand the risk factors for development of life-threatening dehydration, a total of 379 children comprising 243 cases (moderate or severe dehydration) and 136 controls (non or mild dehydration) up to 2 years of age suffering from acute watery diarrhoea were studied. By univariate analysis, the presence of vibrios in stool, withdrawal of breast feeding during diarrhoea, not giving fluids, including oral rehydration solution (ORS), during diarrhoea, frequent purging ( > 8/day), vomiting ( > 2/day) and undernutrition were identified as risk factors. However, by multivariate analysis after controlling for confounders, withdrawal of breast feeding during diarrhoea (odds ratio (OR) = 6.8, p < 0.00001) and not giving ORS during diarrhoea (OR = 2.1, p < 0.006) were identified as significant risk factors. The confounding variables which also contributed significantly to increasing the risk were age ( < or = 12 months; OR = 2.7, p = 0.001), frequent purging ( > 8/day; OR = 4.1, p < 0.00001), vomiting ( > 2/day; OR = 2.4, p = 0.001) and severe undernutrition (%median < or = 60 weight-for-age of Indian Academy of Paediatrics classification; OR = 3.1, p = 0.001). We feel that these findings will be useful for Global and National Diarrhoeal Diseases Control Programmes for formulating intervention strategies for preventing death due to diarrhoeal dehydration.