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Associated infections in persistent diarrhoea--another perspective

A Sibal1, A K Patwari, V K Anand

  • 1Diarrhoea Training and Treatment Unit, Kalawati Saran Children's Hospital and Lady Hardinge Medical College, New Delhi, India.

Journal of Tropical Pediatrics
|April 1, 1996
PubMed
Summary
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Persistent diarrhea in children is often linked to hidden non-gastrointestinal infections like urinary tract infections and respiratory infections. Investigating these infections is crucial for effective treatment and improved outcomes.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Persistent diarrhea (PD) is a significant cause of childhood morbidity and mortality.
  • Non-gastrointestinal infections are often associated with PD but may be clinically unrecognized.

Purpose of the Study:

  • To investigate the prevalence of non-gastrointestinal infections in children with persistent diarrhea.
  • To assess the diagnostic utility of clinical screening versus investigations for these associated infections.
  • To determine the impact of these infections on PD outcomes and mortality.

Main Methods:

  • Retrospective analysis of 78 children aged 1 month to 5 years with persistent diarrhea.
  • Clinical screening for acute respiratory infection (ARI), urinary tract infection (UTI), and acute suppurative otitis media (ASOM).

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  • Diagnostic investigations including chest X-ray, urine culture, and blood culture.

    • Main Results:

    • 54% of children had at least one associated non-gastrointestinal infection; 28% had multiple infections.
    • Urinary tract infection (32%) and pneumonia (39%) were frequently detected by investigations, often missed on clinical screening.
    • E. coli was the most common pathogen in urine and blood cultures.
    • Mortality was associated with severe malnutrition, sepsis, and ARI.

    Conclusions:

    • Persistent diarrhea in children is frequently associated with unrecognized non-gastrointestinal infections, particularly UTI and ARI.
    • Systematic investigation is essential for accurate diagnosis and management of these co-existing infections.
    • Early detection and treatment of associated infections can significantly improve patient outcomes and reduce mortality.