ENVIRONMENTAL AND BEHAVIORAL RISK-FACTORS FOR PROLONGED DIARRHEA IN NIGERIAN CHILDREN

Prolonged diarrhoea is a particular health concern because it contribu tes significantly to diarrhoea-related deaths. Studies of risk factors for prolonged or persistent diarrhoea are virtually nonexistent in Af rica. In the present study conducted in a semi-urban area of Lagos, we used a case-control design to evaluate the roles of household environ ment, mothers' food hygiene behaviour, and child-care practices as pos sible risk factors for prolonged diarrhoea in children 6-36 months old . A total of 628 children were studied. During the 3 1/2 months survei llance period, 166 children became ill with diarrhoea and 20 of the 16 6 (12.0%) had prolonged episodes (> 7 days). Persistent diarrhoea (> 1 4 days) accounted for only 2.4% (6 of 251) of all episodes. This analy sis of risk factors is focussed on the 20 cases of prolonged diarrhoea and 206 randomly selected controls who experienced no diarrhoea durin g the surveillance period. A significantly high risk of prolonged diar rhoea was found among children who were given ogi, a maize pap, as the main diet (odds ratio = 4.13). Children who were fed mainly with food s bought from street vendors also had a significantly higher risk (odd s ratio = 2.91) of prolonged diarrhoea. No association was found betwe en domestic, environmental, and personal hygiene practices and prolong ed diarrhoea. Foods from street vendors may serve as one source of dia rrhoeal illnesses in Lagos and such episodes could be prolonged follow ing repeated exposure, especially in children who are fed mainly with a low-energy and low-nutrient-density diet such as ogi.