CELL-MEDIATED IMMUNE-DEFICIENCY AND MALNUTRITION ARE INDEPENDENT RISK-FACTORS FOR PERSISTENT DIARRHEA IN BANGLADESHI CHILDREN

A community-based longitudinal study was carried out at Matlab, Bangla desh, to investigate the magnitude of the problem of persistent diarrh ea; 705 children aged < 5 y were followed, yielding 7300 child-months of observation in 1 y. Morbidity data were collected every fourth day by home visit, anthropometric status was determined monthly, and cell- mediated immune status was assessed every 3 mo. The incidence of persi stent diarrhea was 34 episodes per 100 child-years; rates were highest in infancy and declined through the remainder of childhood. In a logi stic-regression model, weight-for-height status and immune status were significant predictors of persistent diarrhea. Compared with those at zero Z score, children with weight-for-height at -2 would have a 3.5 times increased risk of persistent diarrhea. Compared with immunocompe tent children, immunodeficient children had about twice the risk of de veloping persistent diarrhea. Thus, nutritional status and cell-mediat ed immune status were important independent risk factors for persisten t. diarrhea.