Characteristics of children hospitalized with severe dehydration and persistent diarrhoea in Bangladesh

The study analyzed data from a systematic sample of children, aged less tha n five years, who presented with persistent diarrhoea (diarrhoea of more th an 14 days duration). It aims to differentiate (a) non-severe persistent di arrhoea (with no or mild dehydration) and (b) severe persistent diarrhoea ( with moderate or severe dehydration), and to identify individual characteri stics associated with severe persistent diarrhoea. In total, 7,505 patients , who represented a 4 % systematic sample of the patient population, were s een during January 1993-December 1995. Of them, 297 (4%) presented with per sistent diarrhoea. The male:female ratio was 2:1. Eighty-three percent of t hem had mild or no dehydration, and 17% had moderate or severe dehydration. Severe malnutrition of the study patients defined as weight-for-age z-scor e < -3, weight-for-length z-score < -3 and length-for-age z-score < -3 were 33.9%, 9.7%, and 22.7% respectively. Only 3% had oedematous malnutrition, and 11% had xerophthalmia. Factors independently associated with severe per sistent diarrhoea by logistic regression analyses were: number of watery st ool > 10 times during the last 24 hours prior to admission (OR, 10.0; CI, 1 .2-87, p=0.03), lower respiratory tract infection (OR, 111; CI, 4.2-2955, p =0.004), and lack of mothers' education (OR, 7.8; CI, 1.4-41.9, p=0.016) af ter controlling for confounders. Awareness and health education of mothers or caregivers and better case management during acute diarrhoeal episode mi ght prevent the development of severe persistent diarrhoea in young childre n. In addition, children with severe persistent diarrhoea might need specia l attention to have adequate rehydration and control of extraintestinal inf ections, including respiratory tract infection.