title: Mortality associated with acute watery diarrhea, dysentery and persistent diarrhea in rural North India.
abstract: Mortality associated with diarrhea was investigated in a longitudinally followed cohort of children under 6 years of age in rural North India. During the followup, 1663 episodes of diarrhea and 23 diarrhea-related deaths were recorded in 1467 children followed up for 20 months.  The case fatality rate was 0.56% for acute watery diarrhea, 4.27% for dysentery, and 11.94% for non-dysenteric persistent diarrhea.  Most of the episodes lasted less than a week; 5.2% became persistent (duration 14 days).  The case fatality rate was similar in episodes of 1 and 2 weeks duration (0.64% and 0.8%) and increased to 13.95% for persistent episodes.  Of the total 86 persistent episodes, 22.1% were dysenteric; the case fatality rate for such dysenteric persistent episodes was 21.1% and for watery persistent diarrhea 11.4%.  Diarrheal attack rates were similar among different nutritional groups, but diarrheal case fatality rates progressively increased with increasing severity of malnutrition; these were 24 times higher in children with severe malnutrition (7.48%) compared to those normally nourished (0.31%).  With availability and use of oral rehydration therapy, dysentery and persistent diarrhea emerge as major causes of diarrhea-related mortality, with underlying malnutrition as a key associated factor.
authors.forename: N
authors.initials: N
authors.lastname: Bhandari
authors.forename: M K
authors.initials: MK
authors.lastname: Bhan
authors.forename: S
authors.initials: S
authors.lastname: Sazawal
mesh_terms: D001208:Asia; D002664:Child Nutritional Physiological Phenomena; D015331:Cohort Studies; D003710:Demography; D003906:Developing Countries; D003967:Diarrhea; D003968:Diarrhea, Infantile; D004194:Disease; D005440:Fluid Therapy; D006262:Health; D015994:Incidence; D007194:India; D007226:Infant Mortality; D008137:Longitudinal Studies; D009026:Mortality; D009748:Nutrition Disorders; D009747:Nutritional Physiological Phenomena; D011153:Population; D011154:Population Characteristics; D011157:Population Dynamics; D012106:Research; D012107:Research Design; D012424:Rural Population; D013812:Therapeutics
keywords: Asia; Child Mortality; Child Nutrition; Cohort Analysis; Demographic Factors; Developing Countries; Diarrhea; Diarrhea, Infantile; Diseases; Health; Incidence; India; Infant Mortality; Longitudinal Studies; Malnutrition; Measurement; Mortality; Nutrition; Nutrition Disorders; Oral Rehydration; Population; Population Characteristics; Population Dynamics; Research Methodology; Rural Population; Southern Asia; Studies; Treatment