title: The effect of misclassification of diarrhoea on estimates of its occurrence, the identification of risk factors, and the assessment of prevention efforts.
abstract: Inaccurate assessment of true diarrhoea status introduces bias into estimates of its occurrence. A cross-sectional study of diarrhoea among 357 children in a rural Kenyan community found the sensitivity and specificity of the mother's report of diarrhoea to be 0.79 and 0.94 respectively, when compared to an independent observation of loose stool consistency. The observed diarrhoea prevalence of 9.5% overestimated the "true" prevalence estimated at 4.8%. With data on an exposure variable, lack of latrine ownership, an observed odds ratio of 2.0 (95% confidence interval (CI) 0.9-4.3) underestimated the "true" odds ratio of 5.4 (95% CI 2.0-14.5). Misclassification of diarrhoea can hinder the identification of communities of high incidence, the determination of risk factors for diarrhoea, and the evaluation of preventive intervention strategies. A precise definition and reliable means of measuring diarrhoea are critical for evaluating prevention or intervention efforts.
authors.forename: J C
authors.initials: JC
authors.lastname: Thomas
authors.forename: C G
authors.initials: CG
authors.lastname: Neumann
authors.forename: R R
authors.initials: RR
authors.lastname: Frerichs
mesh_terms: D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors