FACTORS DETERMINING RECOVERY DURING NUTRITIONAL THERAPY OF PERSISTENTDIARRHEA - THE IMPACT OF DIARRHEA SEVERITY AND INTERCURRENT INFECTIONS

The recovery pattern and outcome were analysed in 261 consecutive chil dren (age 6-36 months) with persistent diarrhoea who underwent inpatie nt nutritional rehabilitation with a rice-lentil (Khitchri) and yoghur t-based diet. Overall, 217 (83%) recovered successfully, as judged by a reduction in stool output and weight gain for a consecutive 3 d. Fai lures were more commonly febrile at admission [odds ratio (OR) 2.3, 95 % confidence interval (CI) 1.1-4.8] and a greater number had culture-p roven sepsis (Fisher's exact test, p < 0.001). Logistic regression ana lysis identified significantly increased risk of treatment failure wit h several admission characteristics, including stool frequency > 5 d(- 1) (OR 2.9, 95% CI 1.6-5.2), vomiting (OR 2.5, 95% CI 1.1-5.7) and sep sis (OR 2.8, 95% CT 1.1-7.5). Survival analysis revealed significantly longer time-to-recovery among children with stool frequency > 5 d(-1) at admission (p < 0.001), suspected sepsis necessitating intravenous antibiotics (p < 0.001) or oral candidiasis (p < 0.05). These findings suggest that severity of diarrhoea and coexisting systemic infections are key determinants of the response to nutritional therapy in childr en with persistent diarrhoea.