Acute Diarrhea In Young Children Research Articles

Intestinal disorders after acute diarrhea in young children and their coprological predictors

Background. After acute diarrhea in young children, intestinal disturbances and even chronic functional intestinal diseases may occur. To date, no pathogenetically based criteria have been found that would indicate the probability of chronic intestinal disorders, just as the mechanisms of their occurrence after acute diarrhea have not been fully elucidated. The objective: to evaluate the frequency and nature of bowel disorders in children of the younger age group within 6 months after a stay in hospital for acute diarrhea and to establish their relationship with coprological indicators — fecal calprotectin (FCР), the content of carbohydrates (reducing substances, RS), lactic acid (LA) and short-chain fatty acids (SCFA) — acetic, propionic and fatty (butyric). Materials and methods. The study involved 47 children aged 6–24 months who were hospitalized for acute diarrhea. Acute enterocolitis (group I) was diagnosed in 18 patients and was caused by Campylobacter jejuni in 12 cases, Escherichia coli O-18 and Escherichia coli O-44 in 3, Salmonella enteritidis in 2 and Yersinia enterocolitica in one case. Rotaviral gastroenteritis (group II) was diagnosed in 11 patients. Another 11 children had acute symptomatic (parenteral) diarrhea (group III) against the background of intestinal infection — acute otitis, pneumonia, pyelonephritis. In 7 children, diarrhea was classified as functional digestive disorder (group IV). Routine clinical tests were supplemented with an examination of feces for the presence of intestinal parasites, Clostridium difficile A/B toxins, adenoviruses, human hemoglobin, RS, FCP, SCFA and LA. Results. Six-month follow-up established that 14 of 18 children in group I had permanent or temporary loose stools. These complaints in 13 cases were combined with episodes of abdominal pain similar to intestinal colic. The same complaints were much less frequent in children of group II (6 and 3 of 11, respectively), group III (4 and 2 of 11) and group IV (only in 2 of 7 children). The rank correlation analysis did not reveal any significant relationships between the intensity and duration of complaints and FCP, RS, LA, and SCFA in patients of groups I and II. On the contrary, in group III, there were multiple correlations of complaints with FCP, RS, LA, and SCFA. In group IV, the association of loose stools with an increase in LA and acetic acid has been found. Conclusions. According to the 6-month follow-up, 57 % of young children with acute diarrhea complained of loose stools and/or recurrent abdominal pain after discharge from the hospital. Most often, intestinal disorders were detected in children who had acute bacterial enterocolitis. There were no correlations between the intensity of post-infectious (bacterial or viral) disorders with FCP, RS, LA and SCFA during hospitalization. In contrast, such associations were numerous in children with symptomatic (parenteral) and functional diarrhea. It was suggested that the studied coprological parameters can be used to predict the state of the intestine after acute diarrhea.

Perception and Practice on the Management of Pediatric Diarrhea in Thailand

Background: Various observational and survey-based studies have shown suboptimal adherence to clinic practice guidelines, on management of pediatric diarrhea in Thailand. Objective: To define clinical practice of acute diarrhea in young children at a quaternary care teaching hospital, and to determine factors associated with the management. Materials and Methods: The authors initially reviewed the medical records of 1,500 children aged one month to five years with a diagnosis code of acute diarrhea between January 2017 and December 2018. The authors excluded children who received treatment from other centers or had other final primary diagnosis. This resulted in 802 cases, from which the authors collected presenting symptoms, investigations, and management. Results: The median age was 16 months (IQR 9, 29). Most children had no documentation of dehydration status (60%) and did not have mucous or blood in their stools (80%). Blood or stool tests were performed in less than 20% of the cases. Advice on lactose avoidance was noted in 16%, while antibiotics and hospital admission were noted in less than 10%. Domperidone was prescribed in 42%, while ondansetron was given in 8.7%. Multivariate logistic regression analyses showed various independent factors associated with lactose avoidance including age of less than 24 months, type of physician, vomiting, and hospital admission, antibiotic used when there was high grade fever of 39℃ or higher, mucous bloody stools, performed blood culture, and stool culture, and hospital admission when there was moderate dehydration, complete blood count, and performed stool culture. Conclusion: Recording dehydration status is suboptimal. Low rates of investigations complied with most clinical scenarios. Findings on the pediatric acute diarrhea-related management may provide future opportunities to improve education and further conduct quality improvement projects among clinicians. Keywords: Antibiotics; Gastroenteritis; Lactose; Probiotics; Racecadotril

Prevalence of Rotaviruses in the Etiology of Acute Diarrhea in Young Children, Clinical forms, Extraintestinal Manifestations and Complications.

Rotavirus is highly contagious factor with dominant feces-oral transmission. Because it is stable in external environment, transmission clusters are possible by close contact, ingestion of contaminated water or food or contact with contaminated surfaces. It survives within hours and days on hands and contaminated surfaces. This makes it the most common enteric and nosocomial pathogen in the world, especially in early childhood. In addition to the rapid dehydration with pronounced electrolyte disturbances, numerous extraintestinal possibilities have been recorded in the clinical picture, which emphasizes the need for prevention of this disease.In the period from 1.02.2018 to 31.01.2020 at the Clinic for Infectious diseases were treated 1060 patients with diarrheal disease, of which 502 children (47.36%). Rotavirus etiology was confirmed in 23.30% of the children. According to the protocols, laboratory and biochemical investigations were done to all 117 children, with tracking parameters and their dynamics of admission and discharge from the hospital. Most of the children, 84 (82.0 6%) are from urban areas, with a more confirmed epidemiological survey of 59 (42.00%). The average age of the children was 8 months, with a small percentage of children on maternal food (breastfed 25, i.e. 21.37%), with high febrile admission in 99% of children with an average temperature of 38.5oC and an average febrile duration of 4 days, with an average of 7 (+ 2.49) of stools and 5 (+ 2.12) of vomiting. There was a significant difference in hematocrit, leukocyte, electrolyte, glycaemia, and CRP values on admission and discharge. There was predominant isonatremic dehydration, and the compensatory mechanisms followed by the values of the electrolytes ABS, Ph, BE showed a tendency to maintain within the physiological limits. The clinical picture of extraintestinal manifestations included bronchitis, mesenteric lymphadenitis, upper respiratory infections and rash.Rotavirus infection is a serious health and economic problem in our country, so it needs continuous prevention and monitoring in order to reduce the incidence, and thus the need for hospitalization and cure of rotavirus disease.

Effect of Zinc Supplementation on the Frequency and Consistency of Stool in Children with Acute Diarrhea.

IntroductionAcute diarrhea in young children is a prevalent and distressing pediatric illness. The role of zinc therapy in the improvement of stool consistency and the shortening of the duration of diarrhea is still controversial. The aim of this study is to assess the effect of oral zinc supplementation in acute diarrhea.MethodsChildren of age 28 days till five years presenting in the outpatient department with acute diarrhea were included. Oral zinc supplementation was included in the anti-diarrheal regime of half of the children (n=50); the other half (n=50) were not given zinc. Mean body weight and the frequency and consistency of stool were noted for both groups on Days 1 and 3.ResultsThe zinc group showed a significantly reduced frequency of diarrheal episodes on the third day of intervention (p<.00001). More children in the zinc group had soft to firm stool consistency than in the non-zinc group (p=.01).ConclusionOral zinc supplementation has a promising role in reducing the duration of diarrhea and improving stool consistency in children with acute diarrhea. Oral zinc supplementation should be made a mandatory part of the anti-diarrheal regime for Pakistani children.

Oral zinc and common childhood infections—An update

Zinc is an essential micronutrient important for growth and for normal function of the immune system. Many children in developing countries have inadequate zinc nutrition. Routine zinc supplementation reduces the risk of respiratory infections and diarrhea, the two leading causes of morbidity and mortality in young children worldwide. In childhood diarrhea oral zinc also reduces illness duration and risk of persistent episodes. Oral zinc is therefore recommended for the treatment of acute diarrhea in young children. The results from the studies that have measured the therapeutic effect of zinc on acute respiratory infections, however, are conflicting. Moreover, the results of therapeutic zinc for childhood malaria also are so far not promising.This paper gives a brief outline of the current evidence from clinical trials on therapeutic effect of oral zinc on childhood respiratory infections, pneumonia and malaria and also of new evidence of the effect on serious bacterial illness in young infants.

Effect of Zinc supplementation on the Management of Acute Diarrhoea in Young Children in Jos, Nigeria: A Double-Blind Randomised Placebo Controlled Clinical Trial.

Diarrhoea is second only to malaria as a cause of death in under five children in Nigeria. Episodes of acute diarrhoea tend to resolve within a few days in healthy children but persist longer in children with malnutrition, impaired cellular immunity and recurrent diarrhoea. Diarrhoea is very common in severe zinc deficient children and has been reported to respond to zinc supplementation as an adjunct to the combined use of oral rehydration therapy and early continued feeding. We study the effect of Zinc supplementation on the severity, duration and recurrence of acute diarrhoea in children in a hospital-based randomized placebo controlled clinical trial at JUTH in Jos. Seventy children 2-24 months of age who were reported to have passed at least 3 or more unformed stools in the previous 24 hours and have had diarrhoea for 7 days or less were randomized to receive Zinc (20mg/day n= 35) or placebo (n= 35) for 14 days. Each patient also had the low osmolar UNICEF-ORS at 75mls/kg. and the child's usual feeds. Weekly follow-up visits were conducted for 12 weeks after the diarrhea episode. Incidence and prevalence of diarrhea were compared between the groups. Neither the attending clinician nor the patient nor the data analyst was aware of who was on the Zinc or the Placebo. 57 children completed 14 days zinc supplementation, however only 54 children completed the three months post zinc supplementation follow-up. Zinc reduces the average number of watery stools by 37% and the mean duration of diarrhea by 39%. zxeZinc supplementation significantly reduced the risk of recurrence of acute diarrhoea by 38%. Supplementing the treatment of acute watery diarrhea with Zinc in just 2 cases will prevent recurrence of diarrhea in one of the children in the following 12 weeks. Fourteen days supplementation of Zinc in the treatment of acute diarrhea in children significantly reduced the average number of watery stools and duration of acute diarrhea. It also reduces the recurrence of diarrhea within three months of completion of supplementation. Zinc supplementation of acute diarrhea management in just two children will prevent diarrhea recurrence in the next three months in at least one child. Keywords : Acute watery Diarrhoea in Children; Zinc supplementation

Effects of live versus heat-killed probiotics on acute diarrhea in young children

Background Diarrhea remains one of the major causes ofmorbidity and mortality in children in developing countries.Probiotics have been shown to be beneficial for decreasing thefrequency and duration of diarrhea. However, the reported effectson reducing the duration of diarrhea have been varied.Objective To compare the effectiveness of live and heat􀁂killedprobiotics in 6􀁂60 month􀁂old children with acute diarrhea fordecreasing duration and frequency of diarrhea and improvingweight gain.Methods We conducted a randomized, single􀁂blind, controlledtrial in children aged 6􀁂60 months with acute diarrhea. Childrenwere randomized into two groups, receiving either live or heat􀁂killed probiotics. All children received standard treatment fordiarrhea and probiotics as adjuvant treatment. The primaryoutcomes were duration and frequency of diarrhea, as well asweight gain. T􀁂test was used for data analysis.Results There were 165 children with acute diarrhea enrolledin this study. They were divided into 2 groups, with 83 childrenreceiving live probiotics and 82 children receiving heat􀁂killedprobiotics. There were no significant differences in diarrhealduration in the two groups. The mean durations of diarrhea inthe live and heat􀁂killed probiotic groups were 3.64 (SD 0.85) daysand 3.74 (SD 0.73) days (P&gt;0.05), respectively. Mean diarrhealfrequencies were also not significantly different, with 3.25 (SD1.44) times per day in the live probiotic group and 3.26 (SD 1.20)times per day in the heat􀁂killed probiotic group (P&gt;0.05). Inaddition, mean weight gain was not significantly different, 'With241.57 (SD 75.84) g in the live prohiotic group and 221.95 (SD85.38) g in the heat-killed prohiotic group (P&gt;0.05).Conclusion There were no significant differences between live andheat􀁂killed probiotics for reducing duration and frequency of diarrhea,as well as in weight gain in children aged 6􀁂60 months 'With acutediarrhea. [paediatr lndones. 2012;52:249-54].

701 Burden of Rotavirus Gastroenteritis Among Hospitalized Infants in Romania

Background and AimsThe rotavirus infection is a major cause of acute diarrhea in young children. The study aimed to evaluate the impact on healthcare and the economic burden associated with...

Effects of live versus heat-killed probiotics on acute diarrhea in young children

Effects of live versus heat-killed probiotics on acute diarrhea in young children

Risk Factors for Extended Duration of Acute Diarrhea in Young Children

Objective and BackgroundWe sought to identify predictors of extended duration of diarrhea in young children, which contributes substantially to the nearly 1 1/2 million annual diarrheal deaths globally.MethodsWe followed 6-35 month old Nepalese children enrolled in the placebo-arm of a randomized controlled trial with 391 episodes of acute diarrhea from the day they were diagnosed until cessation of the episode. Using multiple logistic regression analysis, we identified independent risk factors for having diarrhea for more than 7 days after diagnosis.ResultsInfants had a 17 (95% CI 3.5, 83)-fold and toddlers (12 to 23 month olds) a 9.9 (95% CI 2.1, 47)-fold higher odds of having such illness duration compared to the older children. Not being breastfed was associated with a 9.3 (95% CI 2.4, 35.7)-fold increase in the odds for this outcome. The odds also increased with increasing stool frequency. Furthermore, having diarrhea in the monsoon season also increased the risk of prolonged illness.ConclusionWe found that high stool frequency, not being breastfed, young age and acquiring diarrhea in the rainy season were risk factors for prolonged diarrhea. In populations such as ours, breastfeeding may be the most important modifiable risk factor for extended duration of diarrhea.

Rotavirus in children with diarrhea in Tripoli, Libya

The most common cause of acute diarrhea in young children in developed and developing countries are rotaviruses. In developing countries, it is estimated that 20-70% of hospitalizations and close to one million children below the age of five die annually because of rotavirus infections. Of the seven groups (A-G) of rotaviruses, group A is usually the cause of rotavirus-associated diarrhea. Infections due to rotaviruses occur via the fecal-oral route. Previous studies from Libya showed that rotavirus is the leading cause of infectious diarrhea. However, these studies were carried out more than a decade ago. (Published: 18 February 2011) Citation: Libyan J Med 2011, 6 : 6041 - DOI: 10.3402/ljm.v6i0.6041

Role of probiotic in preventing acute diarrhoea in children: a community-based, randomized, double-blind placebo-controlled field trial in an urban slum

Acute diarrhoea remains a major public health challenge in developing countries. We examined the role of a probiotic in the prevention of acute diarrhoea to discover if there was an effect directed towards a specific aetiology. A double-blind, randomized, controlled field trial involving 3758 children aged 1-5 years was conducted in an urban slum community in Kolkata, India. Participants were given either a probiotic drink containing Lactobacillus casei strain Shirota or a nutrient drink daily for 12 weeks. They were followed up for another 12 weeks. The primary outcome of this study was the occurrence of first episodes of diarrhoea. We assessed this during 12 weeks of intake of study agent and also for 12 weeks of follow-up. There were 608 subjects with diarrhoea in the probiotic group and 674 subjects in the nutrient group during the study period of 24 weeks. The level of protective efficacy for the probiotic was 14% (95% confidence interval 4-23, P<0·01 in adjusted model). The reduced occurrence of acute diarrhoea in the probiotic group compared to nutrient group was not associated with any specific aetiology. No adverse event was observed in children of either probiotic or nutrient groups. The study suggests that daily intake of a probiotic drink can play a role in prevention of acute diarrhoea in young children in a community setting of a developing country.

Valeur des données anamnestiques, cliniques et biologiques pour le diagnostic de déshydratation par diarrhée aiguë chez l’enfant de moins de 5 ans

Acute diarrhea is frequent, costly because of the number of hospital admissions required, and sometimes serious, even fatal to children in France. The clinical diagnosis of dehydration is difficult, but essential to determine management.To summarize the published data on the value of clinical history, clinical signs and laboratory results for diagnosing dehydration during acute diarrhea in young (1 month-5 years) non-malnourished children.Four databases (Medline, INIST, Ovid, and Cochrane) were searched through November 2006, with the key words "dehydration" subcategories "diagnosis, or etiology, or history", "diarrhea" subcategory "diagnosis", and age limits "infant or preschool child". We selected the articles and reviews that included as an endpoint for dehydration "weight gain > 5% after recovery" (the gold standard).Thirteen studies were selected. No single clinical history item, clinical sign or laboratory value was sufficient to discriminate between children with and without dehydration. The reproducibility of clinical signs varied substantially between studies. Persistent skin folds and signs of vasoconstriction contributed the most information, with good specificity but sensitivity < 50%. The combination of at least 3 clinical signs was most discriminative for dehydration. No dehydration scale has been validated. None of the studies selected had a very high level of proof (level 1 and 2); neither signs nor scores have been validated internally or externally because of the low number of subjects.The diagnosis of dehydration due to acute diarrhea in young children depends on the number of signs present, since no individual element of clinical history, clinical picture or laboratory tests distinguished dehydration. Other studies are necessary.

Diffusely adherent Escherichia coli as a cause of acute diarrhea in young children in Northeast Brazil: a case-control study.

In a prospective study carried out in two urban centers in northeastern Brazil, 195 HEp-2-adherent Escherichia coli strains were isolated; 110 were identified as the only pathogen in stools of children with diarrhea, and 85 were from controls. Enteropathogenic E. coli isolates were identified in 21 children with diarrhea (8.9%) and 7 children without diarrhea (3.0%), and they were significantly associated with diarrhea (P < 0.01). Enteroaggregative E. coli strains were isolated from 40 children with diarrhea (16.9%) and 38 children without diarrhea (16.4%) and showed no correlation with diarrhea (P > 0.5). In 49 children with diarrhea (20.7%) and 40 children without diarrhea (17.3%), diffusely adherent E. coli (DAEC) isolates were detected and were not found to be associated with diarrhea (P = 0.41). However, after stratification, for children older than 12 months of age a significant correlation between DAEC infection and diarrhea was detected (P = 0.01). These results suggest that DAEC isolates should be considered potential pathogens in northeastern Brazil and also confirm the association of DAEC with age-dependent diarrhea.

Management of acute diarrhoea with low osmolarity oral rehydration solutions and Lactobacillusstrain GG

Two hypotonic oral rehydration solutions with osmolarities of 224 mosmol/l (Na+ 60 mmol/l, glucose 84 mmol/l) and 204 mosmol/l (Na+ 60 mmol/l, glucose 64 mmol/l), respectively, and oral treatment withLactobacillus...

Rotavirus serotypes causing severe acute diarrhea in young children in six Australian cities, 1989 to 1992.

Rotavirus VP7 serotypes were identified in stools from 72.9% (1,302/1,784) of hospitalized Australian children in six cities (1989 to 1992) and comprised 1,088 (83.6%) serotype G1 isolates, 84 (6.4%) serotype G2 isolates, 64 (4.9%) serotype G3 isolates, 49 (3.8%) serotype G4 isolates, and 17 (1.3%) isolates of mixed serotypes. The most densely populated cities yielded the greatest diversity of serotypes.

Acute diarrhoea and rotavirus infections in young children in Kuwait.

The role of rotavirus infections in acute diarrhoea in young children was studied over a period of one year. Rotavirus was detected by electron microscopy and enzyme immunoassay methods in 40.2% of faecal specimens from 343 children with acute diarrhoea and in 4.7% of 86 controls. The infections were most common in children aged 2-12 months (42.3%). Twelve per cent of the rotavirus infected children were also infected with bacterial enteropathogens (Salmonellae, Shigellae and enteropathogenic Escherichia coli). The incidence of rotavirus infections was not related to sex, socio-economic or nutritional status of children. Rotavirus-associated diarrhoea differed in several clinical parameters from bacterial associated and nonspecific diarrhoea. Rotavirus was detected throughout the year but was most frequent during months with little rainfall and low humidity (March-May). Our results suggest that in Kuwait, rotavirus infection is a major cause of childhood diarrhoea.

Vomiting and acute diarrhoea in young children

Vomiting and acute diarrhoea in young children