Abstract
Diarrhoea contributes significantly to the under-five childhood morbidity and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having “some dehydration” and “dehydration” according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean ± standard deviation age of 25.62 ± 31.85 months; out of which, 70% (95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breastfed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p < 0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p = 0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p < 0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p < 0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.
Highlights
Diarrhoea is the second leading cause of morbidity and mortality among under-5 (U-5) children worldwide [1,2,3]
The World Health Organization (WHO)-led diarrhoeal disease control programme resulted in a steep reduction of 75% in mortality due to diarrhoea worldwide from the
Of the 332 children admitted with diarrhoea, 232 children were diagnosed to have severe dehydration and the remaining had “some dehydration”
Summary
Diarrhoea is the second leading cause of morbidity and mortality among under-5 (U-5) children worldwide [1,2,3]. Childhood diarrhoea results in the death of approximately, 700,000 U-5 children yearly, constituting almost 16% of global child death [2,3]. Apart from deaths, the grave consequence of diarrhoea in the first two years of life is its effect on growth, leading to stunting [4]. The morbidity of childhood diarrhoea is about 3 episodes per child per year, and childhood diarrhoea is concentrated in Southeast Asia and Sub Saharan Africa [1]. Controlling diarrhoeal diseases has been on the public health agenda since long. The World Health Organization (WHO)-led diarrhoeal disease control programme resulted in a steep reduction of 75% in mortality due to diarrhoea worldwide from the
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