Acute Diarrheal Research Articles

Exclusive breastfeeding in Colombia: analysis of data on respiratory infections and acute diarrhoeal diseases

Introduction: Despite the fact that Colombia is the fourth country in the world with the highest concession of maternity leave days, it still does not cover what is defined as essential to reduce Respiratory Tract Infection (RTI) and Acute Diarrhoeal Disease (ADD) in infants. Objective: The objective of this research was to analyze indicators of respiratory infections and acute diarrheal diseases during exclusive breastfeeding (EBF) in Colombia. Methodology: The management of solid research data at the institutional level used as instrument the LERU roadmap for health indicators in institutions attached to the Secretariat of Health of Bogota, based on the case study and matched controls 1: 2, from publications of the SaluData observatory, the Ten-Year Breastfeeding and Complementary Feeding Plan- PDLMAC 2021-2030, as well as the registry book of infants between 0 to 5 months of age, taking as a focused sample the Hospital San Juan de Dios in Colombia, the detection of the occurrence of events that allow formulating a hypothesis in accordance with the variables: breastfeeding and maternity leave; respiratory infections and acute diarrheal diseases. Results: The findings show that there is an association between exclusive breastfeeding during maternity leave to reduce respiratory infections and acute diarrheal diseases in the hospitals attached to the Health Secretariat of Bogota. One in six children does not receive exclusive breastfeeding during maternity leave in Colombia. Conclusion: As implications, the public health strategies must be reconsidered to favor EBF and extend maternity leave times, complying with the 6-month goal defined by the World Health Organization.

Minimal Impact on the Resistome of Children in Botswana After Azithromycin Treatment for Acute Severe Diarrheal Disease.

Macrolide antibiotics, including azithromycin, can reduce under 5 years of age mortality rates and treat various infections in children in sub-Saharan Africa. These exposures, however, can select for antibiotic-resistant bacteria in the gut microbiota. Our previous randomized controlled trial (RCT) of a rapid-test-and-treat strategy for severe acute diarrheal disease in children in Botswana included an intervention (3-day azithromycin dose) group and a control group that received supportive treatment. In this prospective matched cohort study using stools collected at baseline and 60 days after treatment from RCT participants, the collection of antibiotic resistance genes or resistome was compared between groups. Certain macrolide resistance genes increased in prevalence by 13%-55% at 60 days, without differences in gene presence between the intervention and control groups. These genes were linked to tetracycline resistance genes and mobile genetic elements. Azithromycin treatment for bacterial diarrhea for young children in Botswana resulted in similar effects on the gut resistome as the supportive treatment and did not provide additional selective pressure for macrolide resistance gene maintenance. The gut microbiota of these children contains diverse macrolide resistance genes that may be transferred within the gut upon repeated exposures to azithromycin or coselected by other antibiotics. NCT02803827.

Association of Putative Virulence Genes with HEp-2 Cell Adherence and Biofilm Production in Enteroaggregative E. coli Strains Isolated from Acute Diarrheal and Healthy Children, India.

EnteroaggregativeEscherichia coli(EAEC) is an emerging enteric pathogen that causes acute and chronic diarrhea in developed and industrialized countries in children. EAEC colonizes the human intestine and this ability to form colonies and biofilm is an important step in pathogenesis. Here, we investigated the relationship between known or putative 22 EAEC virulence genes and biofilm formation in isolates derived from acute diarrhea and healthy children and their aggregative adherence (AA) pattern with Hep-2 cell lines. A total of 138 EAEC isolates were recovered from 1210 stool samples from children (age < 10years) suffering from acute diarrhea and 33 EAEC strains isolated from 550 healthy children (control group) of different Anganwadi centers in Chandigarh region were included. Polymerase chain reaction using the primer pair pCVD432 identifiedE. coliisolates as EAEC. A total of 22 virulence-related genes have been identified using M-PCR chain reactions. The crystal violet method was used for the quantitative biofilm assay. Aggregative adherence assay was also studied using HEp-2 cell lines. Of 138 EAEC isolates from the acute diarrheal group, 121 (87.6%) EAEC isolates produced biofilm. In our findings, typical EAEC (62%) isolates were strong biofilm producers (37.5%) in the diarrheal group. Among adhesive variants,agg4A (39.6%) andaggA (21.6%) were the most common and were statistically significant (p = 0.01 and p = 0.03 respectively). We reported thatthe aggR gene along with the typical AA pattern was present in 71.4% of the EAEC strains in the diarrheal group, whereas it was present in 44% of the control group. OtheraggR non-dependent genes like ORF3 andeilA may also lead to biofilm formation. In conclusion, there is significant heterogeneity in putative virulence genes of EAEC isolates from children and biofilm formation is associated with the combination of many genes.

An Epidemiological Investigation of Acute Diarrheal Disease Outbreak at Urban Area in Borsad Taluka of Anand District

Introduction: Acute Diarrheal Disease (ADD) is affecting millions of people around the world especially in second world nations now a days. Major pathogenic organisms that cause diarrhea, are transmitted through feco-oral route. We investigated an outbreak of Acute Diarrheal Disease at urban area of Borsad taluka, Anand District of Gujarat state with Objectives: 1. To confirm the existence of an outbreak, 2. To know the magnitude and distribution of the outbreak with reference to time, place and person, 3. To identify the source of infection, mode of transmission and implement control and preventive measures. Method: A Cross Sectional Epidemiological study was carried out to investigate the outbreak of acute diarrheal disease cases in urban area of Borsad taluka. We obtained required information from Chief District Health Office, Anand &amp;, Community Health Centre, borsad, conducted house to house survey and also inspected the sanitation and water supply of the affected area. Results: There were 72 cases of acute diarrheal disease. The overall Attack Rate was 0.43%. Majority of the affected population used non-chlorinated water for drinking. Conclusion: The underlying cause for the outbreak of acute diarrheal disease can be co-related by consumption of contaminated water and food. Keywords: Acute Diarrheal Disease, Borsad, Chlorination, Epidemic Investigation.

Evaluation of a New Norovirus Genogroups GI and GII In Vitro Molecular Diagnostic Assay Using Clinical Specimens Collected from Acute Diarrheal Outbreaks.

Norovirus is a leading cause of acute gastroenteritis (AGE) in Taiwan. To improve diagnosis as part of laboratory surveillance, AGE surveillance was conducted using a new fluorescent probe hydrolysis-based insulated isothermal polymerase chain reaction (PCR) method, the POCKIT system, and the results were compared with those obtained from conventional methods. A total of 119 clinical stool samples from reported AGE outbreaks were collected for this study. From 83 real-time reverse transcription PCR (rRT-PCR) norovirus-positive cases, the POCKIT system identified 78 with a sensitivity of 90.3% in GI genogroup and 96.7% in GII genogroup. The specificity for both GI and GII genogroups was 100%. Overall, the POCKIT system is faster and easier to use than the conventional rRT-PCR method, and because of its high sensitivity and specificity, this system is a promising alternative for the detection of norovirus in patients with AGE, and would benefit public health laboratories for near real-time surveillance of AGE epidemic outbreaks.

Nifuroxazide Has Better Efficacy Than Probiotic Treatment in Adult Patients with Acute Diarrheal Syndrome.

Acute gastroenteritis remains an extremely common problem among the general population. In Western countries, an average person will probably face one or two episodes of gastrointestinal infections every year. The aim of this study was to compare the efficacy of nifuroxazide and probiotic preparation containing lactic acid bacteria in the treatment of acute diarrheal syndrome. The study was prospective, comparative study. Patients who suffered from acute infective diarrhoea for ≤72 hours and had ≥3 unformed stools per day, with no administration of antibiotics during 10 days before enrolment were divided into two groups: nifuroxazide group and the lactic acid probiotic group. All patients received therapies four times a day for three days. Data was collected at the baseline visit (before the initiation of the treatment) and two follow-up examinations on the third and seventh day from the treatment start. The study included 61 patients, 36 in nifuroxazide group and 25 in probiotic group. Nifuroxazide group compared to probiotic group showed faster improvement of patients' condition with lower number of stools three and seven days after therapy start (p=0.001 and p<0.001 respectively) and faster stool consistency normalization. On the seventh day from therapy start medium mushy stool consistency was observed in the majority of patients in nifuroxazide group (n=31, 86%) and only in small number of patients in probiotic group (n=5, 20%). Patients were feeling better and there was a trend of reporting better therapy efficacy in nifuroxazide group. Subjective assessment of therapy tolerability was also better in nifuroxazide group. Compliance to therapy and recommended dietary regime was similar between groups and there were no significant differences between groups regarding age, gender, elevated body temperature, abdominal pain, cramps, nausea and vomiting. Although probiotics are sometimes used in the treatment of acute diarrheal syndrome, nifuroxazide has better efficacy and greater patients' satisfaction. Nifuroxazide can be recommended as the first choice empirical treatment in adult patients with the acute diarrheal syndrome.

As notificações das doenças diarreicas agudas em um município do Pantanal

A Doença Diarreica Aguda (DDA) constitui um problema de saúde pública global, com 1,7 bilhão de casos na infância por ano. Sua ocorrência pode estar relacionada à fatores sociais, culturais, nutricionais e ambientais, tais como baixas coberturas de saneamento básico e a dinâmica das águas de uma região. Em situações de intensas chuvas e inundações os casos de diarreia tendem a aumentar. Considerando o exposto, o presente trabalho visa comparar a ocorrência de diarreia em Cáceres-MT numa série temporal (2015, 2017 e 2018 - 2016 foi excluído por ausência de dados) com os índices pluviométricos e fluviométricos. As ocorrências de diarreia foram extraídas do SIVEP-DDA; os dados sobre pluviosidade foram obtidos em tabelas disponíveis no site do Instituto Nacional de Meteorologia e os dados sobre o nível do rio em planilhas alimentadas e disponibilizadas pela Marinha do Brasil/Serviço de Sinalização Náutica do Oeste. Nos anos de 2015, 2017 e 2018 foram registrados 5.686 casos de diarreia em Cáceres-MT. Os resultados demonstraram que o aumento das ocorrências de DDA está significativamente relacionado com o aumento do nível do Rio Paraguai. Durante os meses de águas baixas, as ocorrências de DDA reduzem 28% em relação ao período de águas altas, porém sem uma relação significativa com a redução do nível do rio. O uso da água não tratada nesta época pode estar contribuindo para o aumento das DDAs, indicando uma relação entre a dinâmica das águas e os casos de diarreia em Cáceres-MT.

Acute Diarrhoeal Disease in Children Aged 6 Months to 24 Months: An In-Hospital Cross-Sectional Study.

Introduction:Diarrheal disease comes second among the causes of death in children under 5 years of old. We are well aware that this common disease is preventable and treatable. But the practice of preventive strategies is not as efficient as it should be.Aims and Objectives:1. To determine the frequency of acute diarrheal disease in children aged 6 months to 24 months attending the immunization clinic of Lourdes Hospital, Kochi, Kerala. 2. To assess the associated factors and practices involved with acute diarrheal disease in the study group.Material and Methods:A cross-sectional study was done in children above 6 months attending immunization clinic in Lourdes hospital during the period from 1st October 2017 to 31st March 2019. After receiving their informed consent, a pretested, semistructured, and validated questionnaire was given to the mothers/caregivers to gather data on socio-demographic characteristics and practices. In order to assess the prevalence of diarrhea, details of the diarrheal episode after the 6 months of age were included in the questionnaire. To eliminate repeats, caution was taken not to include previously recorded data on the diarrheal episode.Discussion and Conclusion:The proportion of children with diarrhea in the study population was 38.7% which was high compared with other studies in the same age group. Many of the practices associated were found faulty and needing rectification which is a Family Physician's area of expertise. The study concludes that there is a need for identifying novel risk factors for diarrhea and educating the caregivers regarding the prevention of diarrhea. Primary Care Physicians/Family Physicians can play an effective role in educating the caregivers.

S2078 Primary Amyloidosis Involving the Entire GI Tract: An Acute Diarrheal Presentation

S2078 Primary Amyloidosis Involving the Entire GI Tract: An Acute Diarrheal Presentation

Correlation Change between the Detection Rate of Pathogens Causing Acute Diarrheal Disease and Climatic Elements in Daegu

Correlation Change between the Detection Rate of Pathogens Causing Acute Diarrheal Disease and Climatic Elements in Daegu

Molecular and Conventional Analysis of Acute Diarrheal Isolates Identifies Epidemiological Trends, Antibiotic Resistance and Virulence Profiles of Common Enteropathogens in Shanghai.

Objective: To investigate prevalence of acute diarrhea in Shanghai and analyze virulence associated-genes and antibiotic resistance of major enteropathogens using combination of conventional and molecular epidemiology methods.Method: The 412 stool specimens were obtained by systematic sampling from diarrhea patients throughout entire year 2016. Bacterial and viral pathogens were identified and bacterial isolates were cultured and screened for antibiotic resistance profiles. Two most prevalent bacteria, Vibrio parahaemolyticus and Salmonella were further typed by multi-locus sequence typing (MLST) and analyzed for presence of virulence-associated genes. The association between virulence genes, resistance phenotypes and genetic diversities was analyzed.Results: Among stool specimens testing positive for pathogens (23.1%), 59 bacterial and 36 viral pathogens were identified. V. parahaemolyticus (27/412, 6.6%), Salmonella (23/412, 5.6%) and norovirus GII (21/412, 5.1%) were three most-commonly found. Most bacterial isolates exhibited high levels of antibiotic resistance with high percentage of MDR. The drug resistance rates of V. parahaemolyticus and Salmonella isolates to cephalosporins were high, such as 100.0 and 34.8% to CFX, 55.6 and 43.4% to CTX, 92.6 and 95.7% to CXM, respectively. The most common resistance combination of V. parahaemolyticus and Salmonella was cephalosporins and quinolone. The dominant sequence types (STs) of V. parahaemolyticus and Salmonella were ST3 (70.4%) and ST11 (43.5%), respectively. The detection rates of virulence genes in V. parahaemolyticus were tlh (100%) and tdh (92.6%), without trh and ureR. Most of the Salmonella isolates were positive for the Salmonella pathogenicity islands (SPIs) genes (87–100%), and some for Salmonella plasmid virulence (SPV) genes (34.8% for spvA and spvB, 43.5% for spvC). In addition, just like the drug resistance, virulence genes exhibited wide-spread distribution among the different STs albeit with some detectable frequency linkage among Salmonella STs.Conclusion: Bacterial infections are still the major cause of severe diarrheas in Shanghai. The most common bacteria V. parahaemolyticus and Salmonella show molecular characteristics consistent with preselection of highly virulent types with exceedingly high level of antibiotic resistance.

Karakteristik Responden dalam Penggunaan Jaminan Kesehatan Pada Era BPJS di Puskesmas Cisoka Kabupaten Tangerang Januari-Agustus 2015

Puskesmas is the main of the program bpjs health. Center role crucial where be the basic health services acting as first contact to the community .The main objective of BPJS is ensure that participants receive the healthcare benefit and the protectionneeds basic health, includes promotive, preventive, curative and rehabilitative treatments.Objectives in this study isto get a profile patient visits Puskesmas Cisoka Tangerang in the era of BPJSjanuary to august 2015. The method used in this study is descriptive with cross sectional method. The respondents in this study is the total patient visits puskesmas cisoka. A measuring instrument in study is data secondary and analysis of data univariat. The result of study has reached 104 respondents. Most patients who visited puskesmas is outpatients as 80,8 %, where 61,5 % of this percentage are women.Health insurance in use outpatients the majority pay own ( patients ) of 78,5 % , where 20,2 % outpatients using health insurance bpjs .The diagnosis of the total visits puskesmas patients suffering ispa the majority of 19,2 % , where ispa is also the percentage of the majority of outpatients .Meanwhile majority of patients diarrhea acute as many as 40 % . The conclusion on this study isvisits patients at puskesmas cisoka most of the patients outpatient with most of patients use health service scheme pay own ( a patient public with the diagnosis most outpatient is tract , while in-patient is acute diarrheal.

Determinants of Acute Diarrheal Disease Among Under-Five Children in Pawi Hospital, Northwest Ethiopia, 2013/14

Background: Diarrhea is one of the leading causes of morbidity and mortality among under-five children nationally and globally. This study identified determinants of acute diarrheal disease among under-five children using hierarchical logistic regression. Objective: This study was conducted to identify determinants for hospitalization of children with acute diarrhea in Pawi Hospital, Benishangul Gumuz Region, Northwest Ethiopia, 2013/14. Methods: A hospital-based case-control study was performed on 148 cases and 442 controls. Data were collected using structured questionnaires. Both bivariate and hierarchical logistic multivariate analyses were carried out to identify the determinants of acute diarrheal. Results: Determinants for acute diarrheal disease were identified. Rural residence [AOR=6.8, 95%CI= (3.3, 14)], mothers having a low education [AOR=4.0, 95%CI= (1.5, 11.0)], living in a non-model households [AOR=2, 95%CI= (1.1, 4.0)] were from socioeconomic variables. Improper child stool disposal [AOR=2. 7, 95%CI= (1.5, 4.8)], not treating water at home [AOR=2. 5, 95%CI= (1.3, 4.6)] were among the environmental sanitation factors. Child`s age 6-11 moths [AOR=3.8, 95%CI= (1.7, 8.9)], bottle feeding [AOR=10, 95%CI= (4.6, 21.9)], being malnourished [AOR=2.3, 95% CI= (1.3, 3.91)], and maternal diarrhea [AOR=8. 8, 95%CI= (4.0, 19.0)] were determinants of acute diarrheal disease in under fives. Conclusions: Acute diarrhea is influenced by factors from all hierarchical levels. Therefore, Avoiding bottle feeding and interpersonal transmission, strengthening women’s education, improving child nutrition; maximizing the health extension package model households and treating water at home are recommended with more emphasis on rural living children.

Mothers' Knowledge and Attitude Regarding Acute Diarrheal Disease at Outpatient Clinic ,Assiut University Children's Hospital

Diarrhea occurs world wide and causes 4% of all deaths. It is most commonly caused by gastrointestinal infections which kill around 2.2 million people globally each year, mostly children in developing countries. In 2008, Egypt prevalence of diarrhea in children aged under five years who receiving Oral Rehydration Solution is 28.4 %. Aim of the study was to assess mothers' knowledge and attitude regarding management of acute diarrhea .Subject and Method: cross sectional study was used. It included 600 randomly selected mothers from Assiut University Children's Hospital during 2012. Data Collection from mothers through two tools; first tool was interview questionnaire sheet. It consisted of two parts; first part included Socio-demographic data and the second part mothers' knowledge about diarrhea. The second tool included likert scale to assess mothers' attitude towards diarrhea. Results: The mean age of mothers was 26.08 ± 5.401, with no significant relation between mothers' age and their knowledge regarding diarrhea . As regards level of education, it was observed that about than two fifth (40.7%) of mothers were illiterate, while only 9.3% of them were high education. 57.8 % of mothers had satisfactory knowledge of about diarrhea. While, 86.2% of them had positive attitude towards diarrheal disease. Conclusion: There was a significant difference between mothers' knowledge and their education level. Also, there was a significant difference between numbers of diarrheal episodes and type of feeding. Recommendations: It is very important to provide good sanitation and improvement of housing conditions especially in rural areas.

病原大腸菌E. coh O-143: K ×1 : H-による集団下痢症について

病原大腸菌E. coh O-143: K ×1 : H-による集団下痢症について

Zinc Treatment for 5 or 10 Days Is Equally Efficacious in Preventing Diarrhea in the Subsequent 3 Months among Bangladeshi Children1–4

We conducted a randomized, double-blind placebo controlled, community trial in rural Bangladesh in children 4–59 mo of age to compare the efficacy of a 5- and 10-d course of zinc therapy on the incidence and duration of diarrhea over the subsequent 90-d follow-up after initial treatment for an acute childhood diarrheal (ACD) episode. Children (n= 1622) with ACD were randomly allocated to either 5 or 10 d of zinc treatment. Female field workers visited each child daily, supervised the administration of zinc, recorded the duration of current episode, and the occurrence and duration of diarrhea over the subsequent 3 mo. The incidence of diarrhea over the 90 d of follow-up did not differ between the 5-d (1.08 ± 1.38 episodes) and 10-d (1.02 ± 1.35 episodes) groups (P= 0.35). Children in both groups experienced a comparable duration of diarrheal episodes (3.1 ± 5.6 d vs. 2.9 ± 5.6 d, 5-d vs. 10-d, respectively;P= 0.64) with a mean difference between groups within the defined range of equivalence. Time to onset of the first episode and the proportion children experiencing diarrhea during the 90-d follow-up also did not differ between groups. These findings suggest that among Bangladeshi children, a 5-d zinc treatment for ACD is as efficacious as 10 d in preventing diarrhea in the subsequent 3 mo.

Acute Diarrheal Syndromic Surveillance

In an effort to identify and characterize the environmental factors that affect the number of patients with acute diarrheal (AD) syndrome, we developed and tested two regional surveillance models including holiday and weather information in addition to visitor records, at emergency medical facilities in the Seoul metropolitan area of Korea. With 1,328,686 emergency department visitor records from the National Emergency Department Information system (NEDIS) and the holiday and weather information, two seasonal ARIMA models were constructed: (1) The simple model (only with total patient number), (2) the environmental factor-added model. The stationary R-squared was utilized as an in-sample model goodness-of-fit statistic for the constructed models, and the cumulative mean of the Mean Absolute Percentage Error (MAPE) was used to measure post-sample forecast accuracy over the next 1 month. The (1,0,1)(0,1,1)7 ARIMA model resulted in an adequate model fit for the daily number of AD patient visits over 12 months for both cases. Among various features, the total number of patient visits was selected as a commonly influential independent variable. Additionally, for the environmental factor-added model, holidays and daily precipitation were selected as features that statistically significantly affected model fitting. Stationary R-squared values were changed in a range of 0.651-0.828 (simple), and 0.805-0.844 (environmental factor-added) with p<0.05. In terms of prediction, the MAPE values changed within 0.090-0.120 and 0.089-0.114, respectively. The environmental factor-added model yielded better MAPE values. Holiday and weather information appear to be crucial for the construction of an accurate syndromic surveillance model for AD, in addition to the visitor and assessment records.

Analysis of the Korean Emergency Department Syndromic Surveillance System: Mass Type Acute Diarrheal Syndrome

ObjectivesThis study was designed to compare the data from the emergency department syndromic surveillance system of Korea in detection and reporting of acute diarrheal syndrome (mass type) with the data from the Korea Food and Drug Administration. And to offer fundamental materials for making improvements in current surveillance system was our purpose.MethodsA study was conducted by reviewing the number of cases reported as acute diarrheal syndrome (mass type) from the Korean Center for Disease Control and Prevention between June, 2002 and July, 2008. And the data were compared with the number of mass food poisoning cases during the same period, reported from the Korea Food and Drug Administration. The difference between two groups was measured and their transitions were compared.ResultsThe emergency department syndromic surveillance system's reports of the numbers of acute diarrheal syndrome (mass type) cases were different from the transition of mass food poisonings, reported by the Korea Food and Drug Administration. Their reports were not accurate and they could not follow the trends of increase in mass food poisonings since 2002.ConclusionsCurrent problems in the emergency department syndromic surveillance system in Korea are mostly related to inaccuracies of daily data reporting system. Manual data input by the reporters could play a big role in such inaccuracies. There need to be improvements in the ways of reporting data, such as automated information transport system linking electronic medical record.

A Controlled Trial of Bismuth Subsalicylate in Infants with Acute Watery Diarrheal Disease

Bismuth subsalicylate is a common constituent of over-the-counter medications for diarrhea. However, it is uncertain whether bismuth offers any more benefit than standard oral rehydration therapy with early feeding. We conducted a placebo-controlled, randomized trial to evaluate the effect of bismuth subsalicylate (100 or 150 mg per kilogram of body weight per day for up to 5 days) on the duration and volume of acute watery diarrhea in 275 male infants and young boys (mean age, 13.5 months). Serum salicylate and bismuth levels were monitored throughout the study and were also measured two weeks after discharge. All the patients received fluid replacement by the oral route and early feeding of easily digestible foods with high caloric density. Diarrhea stopped within 120 hours of admission in 74 percent of the patients given placebo, 89 percent of those given 100 mg of bismuth per kilogram (P = 0.009 vs. the placebo group), and 88 percent of those given 150 mg of bismuth per kilogram (P = 0.019 vs. the placebo group). As compared with the patients given placebo, those given bismuth had significant reductions in their total stool output (P = 0.015), total intake of oral rehydration solution (P = 0.013), and duration of hospitalization (P = 0.005); there was no significant difference between the two groups given bismuth in these clinical outcomes. All measurements of bismuth and salicylate concentrations in blood were well below concentrations considered toxic. No adverse reactions were seen. Treatment with bismuth subsalicylate decreases the duration of diarrhea and is a safe and effective adjunct to oral rehydration therapy for infants and young children with acute watery diarrhea.

Acute Diarrheal Disease in Children under Five Years of Age in the Eastern Province of Saudi Arabia

A follow-up study was conducted in 859 children younger than 5 years who were treated for acute diarrhea at the Diarrhoea Control Center, Dammam, during 1408H (1987-1988). The purpose of the study ...