Risk Factors For Diarrhea Research Articles

Diarrhea Risk Factors Associated with Water, Sanitation and Hygiene Among the Under Five in Kasarani, Nairobi County

Provision of quality water continues to be a challenge in the developing Counties particularly in the informal settlements and Kenya is not an exception. This study assessed diarrhea disease attributable to water, sanitation and hygiene (WASH) among the under five in Kasarani, Nairobi County. The main objective of this study was to establish the association between diarrhea among the under five and Water, Sanitation and hygiene. To achieve this goal Kasarani was categorized into four study environs namely low density high income, Medium density middle income, high density low income and informal settlement low income. Structured questionnaire and hygiene checklist were used as data collection instruments. Association and significant differences between variables were determined using inferential statistics and Chi-square tests. To compare quantitative variables (ANOVA) test was preferred. This study determined that water consumed in Kasarani was a risk for childhood diarrhea (p=0.019). Tap water showed a significantly higher contamination 13.7% than household water container 7.2% for T. Coli Bacteria. The amount of water a household consumed per day was an important risk factor for childhood diarrhea (P=0.001). Overall, Age of a child (P=0.046), water treatment method (P=0.002), method of storage of solid waste P<0.001, quantity and frequencies of water supply (P<0.001) were also found to be the most important risk factors for childhood diarrhea. The study concluded that there was a relationship between childhood diarrhea and water, sanitation and hygiene in Kasarani. The study recommended that Nairobi water and Sewerage Company institute programs that will facilitate adequate and wholesome water supply to HDLI and ISLI residential environs respectively.

Association between handwashing practices and quality of toilets with diarrhea among under-five years children

Background and purpose: The incidence of diarrhea among under-five years children in Indonesia is considerably high. Studies exploring risk factors of diarrhea have been extensively conducted in Indonesia. However, the association between handwashing practices of the mother and quality of toilets with diarrhea among under-five years children are still inconsistent across studies. This study aims to examine the association between handwashing practices of the mother, quality of toilets and the episodes of diarrhea among under-five years children.Methods: A cross-sectional survey was conducted involving 104 under-five years children in Selagalas Village. Samples were selected using systematic random sampling. Data were collected in July 2017 by observation and face-to-face interviews using questionnaires. Bivariate analysis and logistic regression were conducted to examine the association between hand washing practices, quality of toilets and diarrhea among under-five years children.Results: We found more than half of under-five years children (64.42%) had experienced at least one episode of diarrhea over the last three months. We found a significant association between diarrhea with unhygienic toilets with an adjusted odds ratio (AOR) of 2.84 and poor hand washing practices of the mother with AOR of 2.46, however, both have a lower limit of AOR confidence interval that close to one, namely 95%CI: 1.05-5.97 and 95%CI: 1.03-5.87.Conclusion: Poor hand washing practices and unhygienic toilets are associated with the episodes of diarrhea among under-five years children, however, both have a low programmatic importance. Further study should be carried out to understand the association between hand washing practices and quality of toilets with diarrhea. Despite of the low programmatic importance, good hand washing practice should be promoted and access to toilets that meet the health standard must be enhanced.

Risk factors for diarrhoea and malnutrition among children under the age of 5 years in the Tigray Region of Northern Ethiopia.

BackgroundDiarrhoea and malnutrition are the leading cause of morbidity and mortality among children in areas with poor access to clean water, improved sanitation, and with low socioeconomic status. This study was designed to determine the prevalence of diarrhoea, malnutrition and risk factors among children aged 6–59 months in the Tigray Region of Northern Ethiopia.MethodsA community based cross-sectional study design was conducted from June to August 2017 to assess the magnitude and factors associated with diarrhoea and malnutrition among children. A standardized questionnaire was used to collect data on diarrhoea, environmental, demographic and behavioural factors from 610 mother-child pairs. Anthropometric measurements were collected from the children. SPSS ver.21 statistical software was used for analysis. Factors associated with diarrhoea and nutritional status were identified using bivariate and multivariate logistic regression. A p-value ≤ 0.05 was considered statistically significant.ResultsOf the 610 children monitored in this study, the incidence of diarrhoea among 6–59 month-old children in the two weeks preceding the day of the interview day was 27.2% (95% CI: 23.6–31%). Specifically, 35.9%, 9.7%, and 1.8% had 1–2, 3–4 and 5–6 times of diarrhoea episodes in a one year of time, respectively. The prevalence of stunting, underweight, wasting, and acute under-nutrition were 36.1% (95% CI: 31–38.6%), 37% (95% CI: 32–39.6%), 7.9% (95% CI: 5.5–9.7%), and 5.4% (95% CI: 3.8–7.4%), respectively. In a multivariate logistic regression analysis, type of drinking water source [AOR = 3.69; 95% CI: 2.03–6.71], mothers not hand washing at critical times [AOR = 15.42; 95% CI: 2.02–117.78], improper solid waste disposal [AOR = 12.81; 95% CI: 2.50–65.62], and child age (36–47 months) [AOR = 2.57; 95% CI: 1.45–4.55] were found to be predictors of diarrhoea. Being within the age range of 12–23 months was a predictor for wasting [AOR = 4.38; 95% CI: 1.61–11.90] and being underweight [AOR = 4.4; 95% CI: 1.7–11.2]. Similarly, the age range of 36–47 months was associated with wasting [AOR = 2.3; 95% CI: 1.45–3.85] and stunting [AOR = 1.7; 95% CI: 1.03–2.67]. Family size (less than 4) [AOR = 0.56; 95% CI: 0.368–0.959] was inversely associated for wasting.ConclusionsOur study revealed that the problem of diarrhoea and malnutrition amongst 6–59 months children in the study area was significant. Access to clean water was the main problem in the study area. Hence, improving access to clean water and providing health education to mothers on personal and environmental hygiene, and proper waste disposal could improve diarrhoea in the study area. Intervention on children’s nutrition should also be implemented to minimize the problem of malnutrition.

Magnitude and determinants of diarrhea among 0-6 year’s children: a cohort study from central India

Background: Inspite of efforts of all the stakeholders, diarrhea still remains a cause of significant morbidity and mortality in developing country like India.Methods: A follow up study was done among 305 children of 0-6 year’s age to estimate the incidence and risk factors of diarrhea. Diarrhea was defined as more than 3 stools in one day that were more liquid than usual. At each monthly follow up enquiry was made about the occurrence of diarrhea, health seeking, infant feeding practices and dietary history etc. Cumulative incidence, attack rates and risk ratio was used to estimate the burden and risk factors of diarrhea.Results: The number of diarrhea episodes per child per year was 0.65 (95% CI=0.62-0.67). The cumulative incidence of diarrhea among 0-6 years children was 485.7 per 1000 children per year (95% CI=430.8–540.9). In terms of attack rate, the diarrhea among 0-6 years children was 63.5 percent (95% CI=58.1–68.7). Age of child, birth weight, total duration of breastfeeding, anaemia and season were found to be significant risk factors of diarrhea.Conclusions: Further substantial changes in diarrhea incidence will require action on multiple factors like improvement of birth weight of child by better maternal and child health (MCH) care, continued breastfeeding of child till two year of age, correction of anaemia and provision of safe water supply and sanitation during summer and raining season.

Coculture with Clostridium difficile promotes apoptosis of human intestinal microvascular endothelial cells.

ObjectiveThe clostridial triose-phosphate isomerase (tpi) gene is a housekeeping gene that specifically distinguishes Clostridium difficile from other bacteria. This retrospective cohort study was performed to analyze and compare the TPI protein-positive rates in outpatients and hospitalized patients with and without diarrhea (control group).MethodsWestern blotting, methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay, and flow cytometry were used to investigate the pathogenic mechanism of C. difficile in the development and progression of diarrhea in patients with inflammatory bowel disease (IBD).ResultsThe TPI protein-positive rates were significantly higher in patients with diarrhea but without IBD than in the healthy control group as well as in patients with diarrhea and IBD than in patients with diarrhea but without IBD. Coculture with C. difficile inhibited aquaporin-1 protein expression in human intestinal microvascular endothelial cells, which significantly reduced the proliferation of these cells and promoted their apoptosis.ConclusionsClostridium difficile infection is associated with diarrhea and may be an important risk factor for diarrhea in patients with IBD. Coculture with C. difficile may inhibit the proliferation of intestinal mucosal cells and promote their apoptosis, reduce intestinal aquaporin-1 expression, and inhibit intestinal water uptake. Clostridium difficile is one cause of C. difficile-associated diarrhea.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN DIARE PADA ANAK USIA 12-36 BULAN DI DESA CIJORO PASIR WILAYAH KERJA PUSKESMAS RANGKASBITUNG KABUPATEN LEBAK PROVINSI BANTEN TAHUN 2017

Child health problems is one of the main problems in the field of health, until now diarrhoeal disease is still a global health problem, especially in developing countries. From year to year diarrhea remains one of the diseases that cause malnutrition and mortality in children. The incidence of childhood diarrhoeal disease in Cijoro Pasir Village Lebak Regency of Banten Province amounted to 182 (18%) toddlers. The purpose of this study is to determine what factors are associated with the incidence of diarrhea. The type of research is descriptive quantitative research with cross sectional approach. The population in the study was 1010 people and only 94 toddlers were sampled by accidental sampling.Univariate analysis showed that most of the toddlers had diarrhea (53,2%), with low birth weight (55,3%), less nutrition status (51,1%), non-exclusive breastfeeding (54.3%) and incomplete primary immunization (55.3%). Conclusion: There was a relationship between birth weight (p = 0.044), nutritional status (p = 0,000), exclusive breastfeeding (p = 0.026), and primary immunization (p = 0.015) with diarrhea occurrence in toddlers. Toddlers with less nutritional status is the most dominant variable having diarrhea chance with OR = 6,857. Suggestion: To prevent diarrhea occurrence in toddlers, puskesmas could provide the information or giving counseling and education about nutrition status, monitoring and measuring nutrition status and making improvement effort against diarrhea risk factors in toddlers.

Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016

SummaryBackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provides an up-to-date analysis of the burden of diarrhoea in 195 countries. This study assesses cases, deaths, and aetiologies in 1990–2016 and assesses how the burden of diarrhoea has changed in people of all ages.MethodsWe modelled diarrhoea mortality with a Bayesian hierarchical modelling platform that evaluates a wide range of covariates and model types on the basis of vital registration and verbal autopsy data. We modelled diarrhoea incidence with a compartmental meta-regression tool that enforces an association between incidence and prevalence, and relies on scientific literature, population representative surveys, and health-care data. Diarrhoea deaths and episodes were attributed to 13 pathogens by use of a counterfactual population attributable fraction approach. Diarrhoea risk factors are also based on counterfactual estimates of risk exposure and the association between the risk and diarrhoea. Each modelled estimate accounted for uncertainty.FindingsIn 2016, diarrhoea was the eighth leading cause of death among all ages (1 655 944 deaths, 95% uncertainty interval [UI] 1 244 073–2 366 552) and the fifth leading cause of death among children younger than 5 years (446 000 deaths, 390 894–504 613). Rotavirus was the leading aetiology for diarrhoea mortality among children younger than 5 years (128 515 deaths, 105 138–155 133) and among all ages (228 047 deaths, 183 526–292 737). Childhood wasting (low weight-for-height score), unsafe water, and unsafe sanitation were the leading risk factors for diarrhoea, responsible for 80·4% (95% UI 68·2–85·0), 72·1% (34·0–91·4), and 56·4% (49·3–62·7) of diarrhoea deaths in children younger than 5 years, respectively. Prevention of wasting in 1762 children (95% UI 1521–2170) could avert one death from diarrhoea.InterpretationSubstantial progress has been made globally in reducing the burden of diarrhoeal diseases, driven by decreases in several primary risk factors. However, this reduction has not been equal across locations, and burden among adults older than 70 years requires attention.FundingBill & Melinda Gates Foundation.

Prevalance of Diarrheal Disease and Risk Factors in Mid-Western Part of Nepal

A descriptive cross-sectional research design was conducted in the agricultural community of Bardia, Banke, Surkhet and other districts of mid-western Nepal. A total of 310 residents of mid-western Nepal who had experienced diarrhea, of all age groups, were selected by using probability random sampling. Residents or resident family members were interviewed using a semi-structured questionnaire to collect qualitative and quantitative data Simple descriptive statistics were taken from the data collected from the questionnaire for statistical analysis and comparison. Out of 310 diarrhoeagenic patients exhibits the socio-demographic characteristics of the respondents, slightly over half (52.6%) reported as illiterate .16.4% reporting as a farmer and 18.1% reporting as a housewife. The significance test of the prevalence of risk factors for diarrhea. It is expected that all four categories of risk factors for diarrhea are equally responsible for causing diarrhea in the study area.so it is required to examine whether it is valid or not on the basis of sample data. The chi-square test of goodness of fit is used for multinomial distribution of the risk factors. The test results reject (χ2 = 148.471), df =3 and P < 0.001 that the risk factors equally contribute to diarrhea at 5% level. Knowledge and practice seem to be the biggest factor (53.5%) followed by education (23.9%). Malnutrition (2.9%) and flood (9.7%) in causing diarrhea among the given factors. It exhibits the significance test of the prevalence of risk factors of diarrhea in children It is expected that all four categories of the risk factors of diarrhea and children are equally responsible for causing diarrhea in the study areas, so it is required to examine whether it is valid or not on the basis of sample data. chi-square test of goodness of fit is used for multinomial distribution of the risk factors The test results reject( χ2= 65.175), df=3 and p< 0.001 that the risk factors equally contribute to diarrhea at a 5% level. Malnutrition seems most prevalent (43.9%), followed by a shortage of breastfeeding (24.5%), Lack of education of mother towards the disease (16.1%) and vitamin A deficiency (15.5%) prevalent in causing diarrhea in children among the risk factors given. The presence of these risk factors should alert the epidemiologist and clinician to take appropriate measures to decrease the prevalence of diarrheal disease. Proper nutritional support, vitamin A supplementation and diligent search for secondary infection and its treatment is of utmost importance in management. There is still a need to acknowledge the mothers of children having 5 years of old and providing the information regarding diarrheal outbreaks and manage the risk factors of diarrhea to midwestern part of Nepalese as per the national standards to meet the sustainable goal.

Diarrhoeal Disease in Relation to Possible Household Risk Factors in South African Villages.

Diarrhoeal disease is a significant contributor to child morbidity and mortality, particularly in the developing world. Poor sanitation, a lack of personal hygiene and inadequate water supplies are known risk factors for diarrhoeal disease. Since risk factors may vary by population or setting, we evaluated the prevalence of diarrhoeal disease at the household level using a questionnaire to better understand household-level risk factors for diarrhoea in selected rural areas in South Africa. In a sub-sample of dwellings, we measured the microbial quality of drinking water. One in five households had at least one case of diarrhoea during the previous summer. The most widespread source of drinking water was a stand-pipe (inside yard) (45%) followed by an indoor tap inside the dwelling (29%). Storage of water was common (97%) with around half of households storing water in plastic containers with an opening large enough to fit a hand through. After adjusting for confounders, the occurrence of diarrhoea was statistically significantly associated with sourcing water from an indoor tap (Adjusted Odds Ratio (AOR): 2.73, 95% CI: 2.73, 1.14–6.56) and storing cooked/perishable food in non-refrigerated conditions (AOR: 2.17, 95% CI: 2.17, 1.44–3.26). The highest total coliform counts were found in water samples from kitchen containers followed by stand-pipes. Escherichia coli were most often detected in samples from stand-pipes and kitchen containers. One in four households were at risk of exposure to contaminated drinking water, increasing the susceptibility of the study participants to episodes of diarrhoea. It is imperative that water quality meets guideline values and routine monitoring of quality of drinking water is done to minimise diarrhoea risk in relevant rural communities. The security of water supply in rural areas should be addressed as a matter of public health urgency to avoid the need for water storage.

Risk Factors for Diarrhea in Children under Five Years of Age Attending El Amal Maternal and Child Health in Quasar City: A Cross-sectional study

Background: To date, there is a lack in the published literature that reported the riskfactors for diarrhea for under-five children in Egypt.Objectives: we conducted the present cross-sectional study to investigate the role of anumber of possible risk factors for diarrhea among under-five children in Egypt.Patients and methods: The present study was a cross-sectional study that carried outfrom February 2017 to August 2017 at the pediatric outpatient clinics of El AmalMaternal and Child Health in Quasar city.Results and conclusion: A statistically significant higher proportion of patients who didnot exclusively breastfeed were more likely to have more than four episodes of diarrheaper day(p =0.026). Similarly, diarrheal episodes more than four motions per day wassignificantly more prevalent among children who consumed unstored cooked food (p =0.1) or did not receive measles vaccine (p =0.04). Notably, children of mother whoknew the benefits of breastfeeding were less likely to suffer from diarrheal episodes (p <0.001). However, diarrheal episodes per day did not have significant associations withage (p =0.656), sibling number (p =0.645), number of rooms within the house (p= 0.145),and number of people number living in the house (p =0.721).

Diarrhea Prevalence and Sociodemographic Factors among Under-Five Children in Rural Areas of North Gondar Zone, Northwest Ethiopia.

Background Diarrheal disease remains one of the principal causes of morbidity and mortality in infants and children in developing countries, including Ethiopia. Risk factors for diarrhea vary by settings and have important implications for developing intervention strategies to reduce the burden of the disease. Thus, the aim of this study was to assess diarrhea prevalence and sociodemographic factors among under-five children in rural areas of North Gondar Zone. Methods A community-based cross-sectional study was conducted from April to June 2016 among 736 randomly selected households with one child under five years old. A structured questionnaire was used for collecting information on sociodemographic characteristics and diarrheal occurrence. Data was analyzed using SPSS version 20. The bivariate and multivariable logistic regression analysis were used to determine the association between risk factors and diarrheal occurrence, and a p value < 0.05 was taken as statistically significant. Results A total of 736 under-five children and their respondents were enrolled during the study period. Almost all respondents were biological mothers 96.4% (709/736), married 94.2% (693/736), and house wives 86% (632/736). The overall prevalence of diarrheal disease among under-five children was 22.1% (163/743). Of these, children with age group of less than one year old, 7.7 % (57/736), were commonly infected with diarrheal diseases. Children less than or equal to one year [AOR=1.82, 95% CI= (1.39, 4.63)], guardians [AOR=4.37, 95% CI= (1.73, 11.1)], and children with no breast feeding practice [AOR=3.13, 95% CI= (1.62, 6.03)] were the major risk factors for the occurrence of diarrhea. Conclusion Childhood diarrhea remains an important health concern in the study area. Occurrence of diarrhea was statistically associated with child age less than or equal to one year, educational status of mother/guardians, and breast feeding. To minimize the magnitude childhood diarrhea, various designing and implementing strategies, such as health education, child care, breast feeding, and weaning practice, integrated with the existing national health extension are quite essential.

Dose Volume Effect of Acute Diarrhea in Post-Operative Radiation for Gynecologic Cancer

Diarrhea is the primary symptom of concern in acute post-operative radiation-induced enteritis in gynecologic cancer. We retrospectively studied the correlation between the volume of irradiated small bowel and the development of acute diarrhea in these patients. A total of 100 post-operative gynecologic cancer patients were analyzed. Pelvic computed tomography was performed to calculate the volume of irradiated small bowel. A dose-volume histogram was calculated from 5 to 40 Gy at 5 Gy intervals. Patients receiving conventional whole pelvic radiation therapy (RT) were assigned to Group I, and those who received intensity-modulated RT (IMRT) were assigned to Group II. A total dose of 40-50 Gy was delivered at 1.8-2.0 Gy per fraction daily. Acute diarrhea during treatment was scored. All data were expressed as a mean ± standard deviation. Different dose-volume parameters for small bowel in Grades 0-1 and Grades 2-3 diarrhea were calculated by the independent t-test. Univariate analysis of diarrhea risk factors was performed with the independent t-test or Chi-square/Fisher exact test. Of the 77 patients who received conventional RT, 44 (57.14%) experienced Grades 2-3 toxicities. Of the 23 patients who received IMRT, 9 (39.13%) experienced Grades 2-3 toxicities. Concurrent chemotherapy was slightly associated with a higher damage score in both groups (p = 0.028). None of the patient factors (weight, percentage depth dosage, dose fraction, distance from skin to tumor, lymph node metastasis, chemotherapy, block, brachytherapy, hypertension, or diabetes) were correlated with diarrhea in the two groups. The volumes of irradiated small bowel in patients who experienced Grades 2-3 diarrhea were significantly larger than those in patients who experienced Grades 0-1 diarrhea at all dose levels in Group I. V20 (372.19 ± 133.26 cm3, p = 0.004) was an independent factor for developing Grades 2-3 diarrhea in Group I. V25 (290.35 ± 130.22 cm3, p = 0.001) was an independent risk factor for all patients who developed higher score diarrhea. The volume of irradiated small bowel was an independent risk factor for all patients who developed diarrhea, especially those undergoing conventional RT.

Early Intensive Care Unit (ICU) Probiotic Administration Reduces Diarrhea Rates

Introduction: ICU patients have numerous risk factors for diarrhea and Clostridium difficile infection (CDI). Although multiple studies have demonstrated efficacy of probiotics toward CDI prevention, society guidelines—ACG, SHEA, IDSA—have not formally recommended probiotics for primary prevention of CDI, in any setting. A recent study that suggested probiotics administered close to antibiotic administration in hospitalized patients could reduce CDI risk had many exclusion criteria and did not include vulnerable ICU patients. We aimed to see whether probiotic administration to ICU patients was associated with less diarrhea and CDI. Methods: All patients ≥18 years who were admitted to the ICU without diarrhea were included. Physicians were educated the month prior by the medical executive committee regarding initiation of VSL#3 probiotic (VSL pharmaceuticals, Inc.; The Living Shield). Pharmacy and nursing staff reminded physicians about probiotic initiation on all patients admitted to the ICU. In the end, ICU physicians decided who to treat, and when. The study, done in a 20-bed ICU in a 300-bed community hospital took place from January to May of 2016. Results: During the study period, 112 of 474 (23.6%) unique patients were placed on probiotics. Demographic and clinical factors among probiotic treated patients with and without diarrhea are shown in Fig. 1. Data for timing of probiotic administration is shown in Fig. 2. Patients with probiotics administered ≤ 2 days in the ICU had significantly lower rates of diarrhea than those administered probiotics >2 days (Fig. 2). Rates of CDI where not associated with timing of probiotics. Multiple logistic regression analysis (Fig. 3) revealed that tube feeds or parental nutrition (OR 6.8, CI 2.3-20.3, P=0.0006) and antibiotics (> 2 drugs) (OR 6.0, CI 2.1-17.1, P=0.0009) increased risk of diarrhea, whereas early probiotics (≤ 2 days in ICU) reduced diarrhea risk (OR 0.29, CI 0.10-0.86, P=0.026).Figure: Demographic and Clinical Factors among Probiotic Treated Patients With (n=44) and Without (n=68) Diarrhea.Figure: Demographic and Clinical Factors Among Probiotic Treated Patients Based on Timing of Probiotic Treatment in ICU.Figure: Multiple Logistic Regression Analysis of Factors Associated with Diarrhea Among Patients Treated with Probiotics in ICU.Conclusion: Though practicing physicians remain reluctant to utilize probiotics in ICU patients, our data suggest that earlier administration of probiotics is associated with lower diarrhea rates. Future studies must be powered to analyze the association between probiotics and CDI rates.

Sosyodemografik Özellikler ve Beslenme Örüntüsünün İshalli Hastalıklara Etkisi: Olgu-Kontrol Çalışması

Objective: Diarrhea is one of the most important causes of morbidity and mortality in childhood. In this study, possible effects of sociodemographic characteristics and the nutrition pattern on the prevention of diarrhea in children aged 6-24 months have been studied by investigating the frequency and quantities of pre-probiotic consumption. Material and Methods: In this case-control study, children aged 6-24 months who presented with complaints of diarrhea to a university hospital constituted the case group. Children in the same age group who were followed in the well child clinic and did not complain of diarrhea constituted the control group. After obtaining verbal consent from the mothers, data were collected by a questionnaire including items regarding the sociodemographic characteristics of the children and the frequency and daily amount of natural foods with pre-probiotics they consumed. Results: A total of 226 children were enrolled in the study. The case and control groups were found to be similar regarding body weight, sex, and age. We found that children with mothers or fathers educated eight years or less were more at risk of diarrhea. It was also found that children of mothers aged 29 years and younger were 3.48 times more likely to have diarrheal illness. A low socioeconomic level was also a risk factor for diarrhea. It was found that milk, kashar cheese, dry beans, chickpeas, leeks, homemade cakes, and chocolates were consumed more frequently in the diarrhea group than the control group. However, daily consumption amounts of yogurt, dry bean, chickpea, lentil and onion for the children in the control group were significantly higher than the diarrhea group. Conclusion: As a result of this study, children of mothers younger than 29 years of age, children with low parental education level and from families with low socioeconomic level were found to be at risk for developing diarrhea. Although we could not say that the consumption of natural foods containing pre-probiotics inhibits the development of diarrhea at the end of this study, we think that it may be a pioneer for carrying out wider studies on this subject.

Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides an up-to-date analysis of the burden of diarrhoeal diseases. This study assesses cases, deaths, and aetiologies spanning the past 25 years and informs the changing picture of diarrhoeal disease worldwide.MethodsWe estimated diarrhoeal mortality by age, sex, geography, and year using the Cause of Death Ensemble Model (CODEm), a modelling platform shared across most causes of death in the GBD 2015 study. We modelled diarrhoeal morbidity, including incidence and prevalence, using a meta-regression platform called DisMod-MR. We estimated aetiologies for diarrhoeal diseases using a counterfactual approach that incorporates the aetiology-specific risk of diarrhoeal disease and the prevalence of the aetiology in diarrhoea episodes. We used the Socio-demographic Index, a summary indicator derived from measures of income per capita, educational attainment, and fertility, to assess trends in diarrhoeal mortality. The two leading risk factors for diarrhoea—childhood malnutrition and unsafe water, sanitation, and hygiene—were used in a decomposition analysis to establish the relative contribution of changes in diarrhoea disability-adjusted life-years (DALYs).FindingsGlobally, in 2015, we estimate that diarrhoea was a leading cause of death among all ages (1·31 million deaths, 95% uncertainty interval [95% UI] 1·23 million to 1·39 million), as well as a leading cause of DALYs because of its disproportionate impact on young children (71·59 million DALYs, 66·44 million to 77·21 million). Diarrhoea was a common cause of death among children under 5 years old (499 000 deaths, 95% UI 447 000–558 000). The number of deaths due to diarrhoea decreased by an estimated 20·8% (95% UI 15·4–26·1) from 2005 to 2015. Rotavirus was the leading cause of diarrhoea deaths (199 000, 95% UI 165 000–241 000), followed by Shigella spp (164 300, 85 000–278 700) and Salmonella spp (90 300, 95% UI 34 100–183 100). Among children under 5 years old, the three aetiologies responsible for the most deaths were rotavirus, Cryptosporidium spp, and Shigella spp. Improvements in safe water and sanitation have decreased diarrhoeal DALYs by 13·4%, and reductions in childhood undernutrition have decreased diarrhoeal DALYs by 10·0% between 2005 and 2015.InterpretationAt the global level, deaths due to diarrhoeal diseases have decreased substantially in the past 25 years, although progress has been faster in some countries than others. Diarrhoea remains a largely preventable disease and cause of death, and continued efforts to improve access to safe water, sanitation, and childhood nutrition will be important in reducing the global burden of diarrhoea.FundingBill & Melinda Gates Foundation.

Mother’s knowledge, attitude and practice regarding prevention and management of diarrhoea in children in Southern Odisha

Background: Diarrhoeal infections are the fifth leading cause of death worldwide and continue to take a high toll on child health. The objective of the study was toassess and compare mothers’ knowledge, attitude and practice regarding prevention and management of diarrhoea in children.Methods: A hospital based observational study was carried out in the Department of Paediatrics, M.K.C.G. Medical College. Data collected from mothers by questionnaire method.Results: Diarrhoea is more common in less than 2 years of age with males are affected more than females and more cases are seen from rural areas. Diarrhoeal diseases are more common in the lower educated group and low socioeconomic status families with prevalence of overcrowding. 47% mothers had knowledge about diarrhoea, 52% about the aetiology and 58% about risk factors of diarrhoea. Regarding role of breastfeeding in diarrhoea 48% mothers had good knowledge and regarding adverse effects of bottle feeding 56% mothers were aware. In this study only 34% of mothers were aware of assessment of danger signs and dehydration and 27% about treatment of dehydration. 33% mothers had good knowledge on sanitary latrine and safe drinking water uses in prevention and treatment of diarrhoea. Regarding preparation of ORS only 19% mothers had good knowledge, 65% mothers had average knowledge.Conclusions: Among mothers’ knowledge about diarrhoea along with the importance of breastfeeding and the adverse effects of bottle feeding is significantly lacking. Also, the knowledge about assessment, management and practices about diarrhoeal diseases among mothers is significantly less.

Prevalence of diarrhoea, and associated risk factors, in children aged 0-5 years, at two hospitals in Umuahia, Abia, Nigeria

Diarrhoea is the second leading cause of infectious mor­bidity and mortality in children under five years of age. This study aimed at identifying the most common parasites and potential risk factors for diarrhoea among children 0-5 years attending Abia State Specialist hospital and Federal Medical Centre, Umuahia, in south east­ern Nigeria. We used 400 faecal samples from children with diarrhoea –and 200 without– in combination with hospital-based case control and a questionnaire Stool samples were processed with direct normal saline and formal-ether sedimentation method for parasitological stud­ies. More males than females were infected in nearly all age groups in both diarrhoeal and control groups (X2=23.04, df=1, P&lt;0.05: X2=11.52, df=1, P&lt;0.05 respectively). Amachara had more infections (X2=0.15, df=1, P&lt; 0.05). January had the highest rate of infection (22.5%). Main clinical features were watery depositions over 3 times a day, diarrhoea lasting for days, fever, vomiting, and dehydration. Mothers learned about the problem through health workers, television and in medical centers. Risk correlated with mother’s education, occupation, latrine type, waste water disposal, hand washing, kitchen cleaning; sources and storage of water; and bottle milk (P&lt; 0.05).Ignorance greatly con­tributed to the spread of parasitic disease in the area: the government should improve education and other strategies to alleviate the spread of the disease..

Risk factors of diarrhea associated with enteral nutrition in elderly patients with severe disease

Objective To study the risk factors of diarrhea associated with enteral nutrition in elderly patients with severe disease. Method One hundred elderly patients with enteral nutrition from July 2015 to May 2016 were divided into two groups. 36 elderly patients were enrolled in the diarrhea group, while 64 elderly patients without diarrhea were allocated in the control group. Body mss index (BMI) , APACHEⅡscore, whether have hypoproteinemia and mechanical ventilation, whether use antibiotics, antiacids and prokinetics, etc. Information of patients were collected, and relevant data of patients in two groups were analyzed by logistic regression. Results The multivariate logistic regression analysis showed that the most dangerous factors of enteral nutrition associated with diarrhea in patients were hypoproteinemia and mechanical ventilation during enteral nutrition (OR=2.528, 4.184; P<0.05) . Conclusions The serum protein should be assessed before carrying out enteral nutrition in elderly patients in case the presence of hypoproteinemia. For elderly patients with mechanical ventilation, the speed of enteral nutrition should slow down, the dose should be reduced with intermittent infusion. Key words: Enteral nutrition; Diarrhea; Intensive care unit (ICU); Elderly patients

Risk Factors of Diarrhea in Children Under Five Years in Urban Slums

Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to identify factors associated with the disease. This study was carried out to investigate the risk factors of diarrhea in children under five years of age in urban slums.&#x0D; &#x0D; Methods: Parents of all children under five years from the urban slums of Tansen municipality, Palpa, Nepal were interviewed using a standardized pretested questionnaire and proforma. Parental variables, environmental factors, and presence of diarrhea in those children in past three months were collected by trained enumerators and the data were analyzed with statistical software SPSS-10.&#x0D; &#x0D; Results: A total of 450 under five years children were enrolled in the study. There were 216 (48%) male and 234 (52%) female children with F:M ratio of 1.08:1. Occurrence of diarrhea was lower if the children were breast-fed for more than six months, well-nourished, used fountain water for drinking, or used boiled or treated water. Similarly, diarrhea prevalence was lower if father had a regular job, daily income in the family was more than one US dollar, there was a toilet in the house, practice of hand washing was followed before feeding or preparing food, or there was no child suffering from diarrhea in the neighborhood.&#x0D; &#x0D; Conclusion: There are a few variables that are significantly related to diarrhea in children under five years of age. In order to decrease the diarrheal episodes in children in the slums of the developing countries, priority could be given in the improvement of those variables.

Is Exposure to Animal Feces Harmful to Child Nutrition and Health Outcomes? A Multicountry Observational Analysis.

It has recently been hypothesized that exposure to livestock constitutes a significant risk factor for diarrhea and environmental enteric disorder in young children, which may significantly contribute to undernutrition. To date, though, very little research has documented the extent of exposure to animal feces and whether this exposure is associated with child anthropometry in large samples and diverse settings. This study investigates these issues using data from the Alive and Thrive study conducted in rural areas of Ethiopia, Bangladesh, and Vietnam. These surveys used spot-checks to collect data on proxies of hygiene behaviors such as the cleanliness of mothers, young children, and the homestead environment, including the presence of animal feces. Animal feces were visible in 38–42% of household compounds across the three countries and were positively associated with household livestock ownership and negatively associated with maternal and child cleanliness. One-sided tests from multivariate least squares models for children 6–24 months of age indicate that the presence of animal feces is significantly and negatively associated with child height-for-age z scores in Ethiopia (β = −0.22), Bangladesh (β = −0.13), and in a pooled sample (β = −0.11), but not in Vietnam. There is also suggestive evidence that animal feces may be positively associated with diarrhea symptoms in Bangladesh. The results in this article, therefore, contribute to a growing body of evidence suggesting that animal ownership may pose a significant risk to child nutrition and health outcomes in developing countries.