title: Persistent diarrhoea: management in algorithmic approach using a low-cost rice-based diet in severely malnourished Bangladeshi children.
abstract: Easy and successful dietary management of persistent diarrhoea has been a long desired goal. Finding an efficient diet which is economically feasible, and easy to prepare in poor homes of developing countries, has not been easy. A dietary algorithm was followed to test the clinical efficacy of an inexpensive and easy to prepare diet made up with rice powder, egg white, glucose, and soya oil. We studied a cohort of 100 severely malnourished children aged between 3 and 36 months with persistent diarrhoea in Dhaka Shisu (children's) Hospital, Bangladesh, during 1990. Initially on a milk-based diet, 26 children (26 per cent) improved while on a subsequent rice-based diet; 65 (88 per cent) of the remaining 74 children improved within a week, with a mean recovery period of 4 days. Patients who did not improve with the rice-based diet were weaned earlier than those who improved. Nine patients failed to improve on the rice-based diet. They were given a soya formula, and only two improved. The remaining seven patients finally improved when a comminuted chicken diet was given. Eight patients died in the hospital with secondary infections of septicaemia and bronchopneumonia. This study offers a simple and effective algorithm on the management of persistent diarrhoea and also demonstrates the success of a rice-based diet, showing promising and feasible means of management of persistent diarrhoea in patients with severe malnutrition.
authors.affiliation: Department of Paediatrics, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Sher-e-Bangla Nagar.
authors.forename: M S
authors.initials: MS
authors.lastname: Akbar
authors.forename: S K
authors.initials: SK
authors.lastname: Roy
authors.forename: N
authors.initials: N
authors.lastname: Banu
mesh_terms: D000465:Algorithms; D001459:Bangladesh; D002675:Child, Preschool; D002908:Chronic Disease; D003681:Dehydration / Q000175:diagnosis; D003968:Diarrhea, Infantile / Q000150:complications* / Q000628:therapy*; D004035:Diet Therapy / Q000191:economics; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D009748:Nutrition Disorders / Q000150:complications*; D012275:Oryza; D016896:Treatment Outcome