Study identifies risk factors for prolonged diarrheal duration, complications in children

A new pediatric study has found that younger age, malnourishment, dehydration, fever, dysentery (bloody stool), longer duration of diarrhea prior to admission, and the failure to treat diarrhea with medication put children suffering an acute bout of diarrhea at increased odds of experiencing a prolonged course or complication.

Key Point: Children suffering from acute diarrheal episodes and with identified risk factors should be monitored closely and treated aggressively to decrease mortality risk.

India’s National Family Health Service estimates that approximately 9% of children under the age of 5 suffer from diarrhea and 1% will have blood in their stools in a given 2-week period. The World Health Organization reports about one-third of hospital admissions in developing countries are due to diarrhea-related diseases, and 17% of these admissions end in death.

In this study, published in the Indian Journal of Pediatrics, data from a micronutrient clinical trial were used to identify risk factors for prolonged diarrheal duration and complications in[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] 808 Indian children (6 months to 59 months or age) hospitalized for an acute bout of diarrhea.

The researchers found fever (odds ratio=1.10), dehydration (odds ratio =1.32), dysentery (odds ratio =1.41), those who received medications (odds ratio =1.19) and weight for age (odds ratio =1.25) were associated with increased odds of prolonged diarrhea. Moreover, diarrhea lasting longer than 7 days was associated with younger age (odds ratio=1.08), female gender (odds ratio =2.33), diarrheal duration (odds ratio =1.06), fever (odds ratio =1.70), and body weight for age (OR=4.32).

Of note, zinc supplementation, poorer sanitation (water safety and hand washing), and baseline anemia had no impact on diarrhea duration.

Data from the study also suggested that children dehydrated at admission were at an over 5-fold increased odds of developing a complication, including severe dehydration, electrolyte imbalance, hemolytic uremic syndrome, septicemia, severe anemia, malaria, pneumonia, meningitis, or death.

Source: Patel AB, Ovung R, Badhoniya NB, Dibley MJ. Risk factors for predicting diarrheal duration and morbidity in children with acute diarrhea. Indian J Pediatr. 2011 Sep 24. [Epub ahead of print] PubMed PMID: 21948223.

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This entry was posted in Infectious Disease, Pediatrics, Primary Care and tagged , , , , , , , , , , , . Volume: .

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