COMMON DIARRHEA PATHOGENS AND THE RISK OF DEHYDRATION IN YOUNG-CHILDREN WITH ACUTE WATERY DIARRHEA - A CASE-CONTROL STUDY

The role of common diarrheal pathogens in dehydration was examined in children with acute watery diarrhea who attended the treatment center of the International Centre for Diarrhoeal Disease Research, Banglades h, in Dhaka. Two hundred sixty-nine children with moderate or severe d ehydration were matched with 700 children with no dehydration. Vibrio cholerae 01 infections were 5.5 times more likely to be associated wit h dehydration than in cases without this agent. No significant associa tion could be found between the presence of enterotoxigenic Escherichi a coli, Campylobacter jejuni, or rotavirus infection and dehydration. These results were obtained after simultaneously controlling for age, lack of oral rehydration therapy (ORT) at home, protein energy malnutr ition, withdrawal of breast-feeding during diarrhea at home, poor hous ing, longer duration of diarrhea at home, and delay in reaching the tr eatment center. The cholera isolation rate was only 4.5% and thus expl ains only a small proportion of the cases of dehydration. In cholera-e ndemic areas, a strategy to prevent dehydration in small children is n eeded to ensure correct use of ORT at home, prompt referral, and the u se of a suitable antibiotic when cholera is clinically suspected.