EARLY CHILD HEALTH IN LAHORE, PAKISTAN .7. DIARRHEA

This study was carried out to obtain reliable prospective data on the incidence, home management and duration of infantile diarrhoeal diseas e. in a developing and rapidly urbanizing community. Fourteen hundred and seventy six infants from 4 different communities of Lahore, repres enting different stages of urbanization, were followed prospectively f rom birth to 2 years of age. Each child had an average of 3.6 episodes of diarrhoea during one year; 4.3 episodes per child per year in the village, 4.4 in the periurban slum, 3.4 in the urban slum and 1.4 in t he upper middle (Um) class control group. The maximum incidence of dia rrhoeal episodes occurred in children between 9-10 months of age. No s ex difference was found. The seasonal variation showed a peak incidenc e during April-June. Bloody diarrhoea, in 3-5% of the episodes, was pr edominantly seen in winter months and in older infants. The maximum us e of ORS was seen in the Um class (53%). Antibiotics were used in 75% of all diarrhoeal episodes maximally in the Um class, and morphine der ivatives in 1% of all cases. The overall incidence of persistent diarr hoea was 14% of all acute cases, being highest in the village (18%), f ollowed by the periurban slum (14%), Um class (10%) and urban slum (8% ) with peak incidence occurring in June and July. Our results confirm the magnitude of the problem of diarrhoea. The proper selection of coh orts, the closely controlled prospective and simultaneous follow-up st udy of these large samples representing different urbanization stages and socio-economic conditions and the new detailed data on the duratio n of diarrhoeal episodes makes these results of wider international in terest in addition to its importance for health planning in Pakistan. Pakistan