Persistent diarrhoea in Nigerian children aged less than five years: a hospital-based study

To identify possible risk factors for persistent diarrhoea, 307 children with acute diarrhoea presenting at the University College Hospital, Ibadan, Nigeria over a 10-month period from July 1993 to April 1994 were followed up prospectively until the resolution of the illness. The children were aged 6-60 months. In 36 (11.7%) of them, diarrhoea became persistent (i.e. lasted more than 14 days). This hospital frequency of 11.7% of persistent diarrhoea is, as expected, higher than the figures from previous community-based studies of diarrhoea from Nigeria. The major factor associated with persistent diarrhoea was poor nutritional status. Mean z scores of weight-for-height and weight-for-age were significantly lower in the persistent diarrhoea group, while mean z scores of height-for-age were similar in the two groups. The frequencies of occurrence of undernutrition, marasmus and kwashiorkor were also higher in the persistent diarrhoea group. Therefore, in common with studies from other regions of the world, malnutrition is an important risk factor for persistent diarrhoea in this group of Nigerian children. The implication of these findings is that reduction in the prevalence of malnutrition may be associated with reduction in the proportion of acute diarrhoeal episodes that eventually progress to persistent diarrhoea.