Diarrheal illness in a cohort of children 0–2 years of age in rural Bangladesh: I. Incidence and risk factors

Abstract

To describe clinical characteristics and age- and season-specific incidences of diarrheal episodes, and to evaluate risk factors associated with the occurrence of diarrheal disease. A total of 252 infants from rural Bangladesh were followed through household surveillance for 2 y from birth during the years 1993-1996. Demographic and household determinants were linked to the probability of illness using logistic regression models. The overall incidence of diarrhea was 4.25 episodes per child per year. Peak rates of overall, acute, and persistent diarrhea occurred in the 6-11-mo and 12-17-mo age groups. Diarrheal rates peaked during the spring and summer. Among host-related characteristics, having a sibling in the household and having had prior diarrhea were significant risk factors for diarrhea. Among environmental characteristics, spring season remained a highly statistically significant risk factor for diarrhea. Diarrheal disease continues to be a substantial burden in young children in rural Bangladesh. Most diarrheal episodes are of short duration, and should primarily be treated with oral rehydration therapy to prevent diarrhea-related mortality. Improved knowledge of oral rehydration therapy, feeding during episodes to prevent further malnutrition, prolonged breastfeeding, and the keeping of livestock in corralled areas of the home are advocated.