Clinical profile and risk factors for persistent diarrhoea in children under five years of age in an urban referral centre

Abstract

Background: Persistent diarrhoea is a known cause of childhood mortality, morbidity and malnutrition in developing countries. The present study was conducted with the aim to study the clinical profile of persistent diarrhoea in children under 5 years of age and to find the possible host and environmental risk factors associated with persistent diarrhoea.Methods: The present descriptive study was conducted on 70 children with persistent diarrhoea, between age of 1 month and 5 years who admitted to DTTU, ICH & HC, Chennai during the period from February 2005 to September 2006. Detailed history was elicited from the parents usually mother regarding illness and risk factors were noted. The children were subjected to detailed clinical examination to assess dehydration, malnutrition, parenteral infections, and nutritional status. Univariable and multivariable logistic regression analyses were used to find risk factors associated with the incidence of diarrhoea.Results: Most of the children (35.71%) were under the age of 6 months to one year. Male (55.71%) children are more affected than female (44.29%) children. Undernutrition was observed in 85.71% of cases. Parenteral infection (44.28%) was noticed as major risk factor among children. E. coli was the organism isolated from stool culture in about 73.91% of cases with gut infection. The total fatality rate in the study population was 10%. Multivariable regression revealed significant associations between persistent diarrhoeal disease in children and protein energy malnutrition (OR- 1.812; 95% CI- 1.406-2.335), irrational antibiotic use (OR- 2.414; 95% CI- 1.195-4.877), parenteral infection (OR- 2.275; 95% CI-1.165-4.443) and use of unsafe drinking water (OR- 2.738; 95% CI- 1.221-6.143) and were found to be independent risk factors. Other factors found to be insignificant.Conclusion: The results of the study conclude that protein energy malnutrition, irrational antibiotic use, use of unsafe drinking water and parenteral infections are the significant risk factors for the incidence of diarrhea in the present study population. Hence, it is important to increase the awareness in parents regarding nutrition and safe drinking water use for children. Prompt diagnosis and appropriate treatment by the doctors can decrease the fatality rates.