Assessing diarrhoea-induced dehydration at the community level.
A community based study of children under 5 years of age in Nampula, Mozambique, assessed children with diarrhoea for the 12 signs and symptoms of dehydration listed in the World Health Organization's Diarrhoea Treatment Chart and for the additional indicators of observed thirst and reported fever. The point prevalence of diarrhoea was 13.1%. The signs and symptoms of dehydration reported by carers were compared with signs detected on physical examination at the time of the interview. The presence of four or more stools, a history of drinking either more or less than usual, and reported fever in the preceding 24 h had the highest sensitivities. Individual symptoms with the highest specificity were decreased urine output, vomiting, and the passing of 10 or more stools during the 24 h preceding the interview. The combination of fever or vomiting had a sensitivity of 68.3% and a specificity of 55.9%, whereas a combination of vomiting or drinking more than usual or fever had a sensitivity of 87.8% and a specificity of 34.1%. These findings are compared with the results of similar studies conducted in different clinical and cultural settings.
Herman
E
E
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205.
Cutts
F
F
Soares
A
A
D002675:Child, Preschool; D016000:Cluster Analysis; D003153:Community Health Services; D003681:Dehydration / Q000453:epidemiology* / Q000209:etiology; D003967:Diarrhea / Q000150:complications / Q000453:epidemiology*; D006701:Home Nursing; D006801:Humans; D009073:Mozambique / Q000453:epidemiology; D010808:Physical Examination; D015995:Prevalence; D011786:Quality Control; D012680:Sensitivity and Specificity; D014944:World Health Organization