Risk factors of persistent diarrhea in children below five years of age.
OBJECTIVE
Persistent diarrhea is a known cause of childhood mortality, morbidity and malnutrition in developing countries. This study was conducted to find out the host and environmental risk factors associated with persistent diarrhea in Bangladeshi children below 5 years of age.


METHODS
Prospective analytic case-control study.


METHODS
Tertiary hospital in Dhaka, Bangladesh.


METHODS
Fifty children with persistent diarrhea and 50 controls with acute diarrhea (matched for age and sex) comprised the study subjects.


RESULTS
Most of the children (82%) were aged below 2 years. Among the risk factors, Grade III malnutrition (p<0.008), irrational antibiotic use during acute diarrheal episode (p<0.0000005), use of unsafe drinking water (p<0.004) and lack of exclusive breast-feeding up to the first four months of life (p<0.004) were significantly associated with persistent diarrhea. Logistic analysis showed irrational antibiotic use (p<0.0001) during an episode of acute diarrhea and lack of exclusive breast-feeding (p<0.05) during the first four months of life as independent risk factors associated with persistent diarrhea.


CONCLUSIONS
Improvement of nutritional status, encouraging exclusive breast-feeding during the first four months of life, discouraging the irrational use of antibiotic for the treatment of acute diarrhea, and provision of safe drinking water may be important for the prevention of persistent diarrhea as these have been identified as risk factors in Bangladeshi children below five years of age.
Karim
A S
AS
Department of Pediatric Nutrition and Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh. karimb@bangla.net
Akhter
S
S
Rahman
M A
MA
Nazir
M F
MF
D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires