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Risk factors for development of dehydration in children aged under five who have acute watery diarrhoea: a
S P Zodpey1, S G Deshpande, S N Ughade
1Department of Social and Preventive Medicine, Government Medical College Hospital, Maharashtra State, India.
Insights
Infancy, poor hygiene, and not receiving oral rehydration salts (ORS) or home available fluids (HAF) are key risk factors for dehydration in young children with acute watery diarrhea. Addressing these preventable factors can significantly reduce severe dehydration cases.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Dehydration is a major complication of acute watery diarrhea in children under five.
- Identifying specific risk factors is crucial for effective prevention and management strategies.
Purpose of the Study:
- To identify and analyze factors contributing to the development of moderate or severe dehydration in young children experiencing acute watery diarrhea.
Main Methods:
- A hospital-based, unmatched case-control study was conducted with 387 cases (severe/moderate dehydration) and 387 controls (mild/no dehydration).
- Risk factors were assessed using univariate and multivariate logistic regression analyses.
Main Results:
- Significant risk factors identified include infancy, severe undernutrition, poor maternal hand hygiene, high stool frequency (>8/day), frequent vomiting (>2/day), recent measles history, cessation of breastfeeding, reduced fluid intake, and lack of ORS/HAF administration.
- Factors such as religion and living in urban slums or rural areas also showed significance.
Conclusions:
- Preventable risk factors like poor hygiene, inadequate fluid intake, and lack of access to oral rehydration salts (ORS) or home available fluids (HAF) significantly increase dehydration risk.
- Timely interventions targeting these modifiable factors can effectively prevent moderate to severe dehydration in children with acute watery diarrhea.
Objective:
To identify factors for development of dehydration in under five year olds with acute watery diarrhoea.
Design:
Hospital based unmatched case-control study.
Setting:
Diarrhoea Treatment Unit, Government Medical College Hospital, Nagpur, India.
Participants:
The study included 387 cases of diarrhoea having severe or moderate dehydration and 387 controls suffering from diarrhea with mild or no dehydration.
Risk Factors:
The study included infancy, female sex, religion, residing in urban slums or rural area, under nutrition, cessation of breast feeding during diarrhoeal episode, fluid intake decrease/stopped during diarrhoea, ORS not received, home available funds (HAF) not received, both ORS and HAF not received, non-washing of hands by mother before preparation of food, after defaecation, after disposal of faeces, history of measles in the previous six months, frequency of stools > 8/d, frequency of vomiting more than twice per day and temperature more than 99 degrees F, as risk factors for development of dehydration.
Statistical Analysis:
Univariate analysis included OR, 95% CI for OR and Chi-square test. Multivariate analysis was carried out by unconditional multiple logistic regression (MLR).
Results:
This study identified the significance of infancy, religion, severe undernutrition, non-washing of hands by mother before preparation of food, frequency of stool > 8/d, frequency of vomiting > 2/d, history of measles in previous six months, withdrawal of breast feeding during diarrhoea, withdrawal of fluids during diarrhoea and not giving ORS, HAF or both during diarrhoea, in the outcome of development of moderate or severe dehydration.
Conclusions:
Timely intervention in the preventable risk factors included in this study may prevent the development of moderate or severe dehydration in the children suffering form acute watery diarrhoea.