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Changing trend of persistent diarrhoea in young children over two decades: observations from a large diarrhoeal disease hospital in Bangladesh.

AbstractAIM:
  We studied the changing trend and factors associated with persistent diarrhoea (PD) in under-five children presenting to a large diarrhoeal disease hospital in urban Dhaka, Bangladesh, over the last two decades.
METHODS:
  We used an unmatched case-control design, with a case (persistent diarrhoea; n=944) to control (acute diarrhoea; n=2832) ratio of 1:3 attending the Dhaka Hospital of icddr,b between 1991 and 2010.
RESULTS:
  The proportion of children with PD decreased significantly from 8% in 1991 to 1% in 2010. The proportion of breastfeeding practices, measles vaccination coverage and vitamin A supplementation among 12-59 months old improved from 79% to 85%, 69% to 85% and 26% to 74%, respectively, which were significant. Although the isolation of rotavirus from stool in children with PD and acute diarrhoea increased, the isolation of Shigella spp., and Vibrio cholerae O1 decreased significantly. In a logistic regression analysis, wasting (OR=1.62), use of antibiotic before attending hospital (OR=5.94), absent clinical dehydration (OR=1.53) and bloody/mucoid stool (OR=3.33) were significantly associated with persistent diarrhoea.
CONCLUSION:
  There, thus, is a need to integrate an appropriate and sustainable deterrent strategy to take the benefit of the significant reduction in prevalence as well as risks of PD in such population.
AuthorsSumon Kumar Das, Abu Syed Golam Faruque, Mohammod Jobayer Chisti, Mohammad Abdul Malek, Mohammed Abdus Salam, David A Sack
JournalActa paediatrica (Oslo, Norway : 1992) (Acta Paediatr) Vol. 101 Issue 10 Pg. e452-7 (Oct 2012) ISSN: 1651-2227 [Electronic] Norway
PMID22734659 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.
Chemical References
  • Anti-Infective Agents
  • Measles Vaccine
  • Vitamin A
Topics
  • Anti-Infective Agents (administration & dosage)
  • Bangladesh (epidemiology)
  • Breast Feeding (trends)
  • Case-Control Studies
  • Child, Preschool
  • Diarrhea (epidemiology, microbiology)
  • Feces (microbiology)
  • Female
  • Humans
  • Infant
  • Interviews as Topic
  • Logistic Models
  • Male
  • Measles Vaccine (therapeutic use)
  • Prevalence
  • Risk Assessment
  • Rotavirus (isolation & purification)
  • Shigella (isolation & purification)
  • Thinness (epidemiology)
  • Vibrio cholerae O1 (isolation & purification)
  • Vitamin A (administration & dosage)

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