Diarrhoea in elderly people: aetiology, and clinical characteristics.
We examined the characteristics of elderly people attending the Dhaka Hospital of ICDDR,B. The hospital has a diarrhoeal disease surveillance system that enrols a 2% systematic sample of all patients visiting the hospital. We reviewed data of all patients enrolled into the surveillance system (n = 13,782) over the period 1996-2001 to identify patients aged 60 y and above for inclusion into the current study (4% of all surveillance patients; n = 478). V. cholerae O1 was the most common enteric pathogen isolated from faecal culture of the patients (20%), followed by ETEC (13%), Shigella (11%), V. cholerae O139 (10%), Campylobacter jejuni (5%), Salmonella (3%), EPEC (2%), rotavirus (4%), and E. histolytica (2%). The isolation rate of V. cholerae O139 and Shigella was higher among the elderly compared to adults (15-59 y of age, 10% vs 6%, and 11% vs 7% respectively; p < 0.05 for both comparisons). Compared to 15-59-y-olds, a significantly higher proportion of the elderly had visible blood in stools (8% vs 5%), required short-stay ward admission (86% vs 82%) or referral (1% vs < 1%) to a health facility. Early initiation of oral or i.v. rehydration therapy, prompt referral, and immediate clinical diagnosis for assessment of the need for antibiotic therapy might be beneficial for the elderly.
Faruque
Abu S G
AS
From the Clinical Sciences Division, ICDDR, B: Centre for Health and Population Research, GPO Box 128, Dhaka 1000, Bangladesh. gfaruque@icddrb.org
Malek
Mohammed A
MA
Khan
Ashraful I
AI
Huq
Sayeeda
S
Salam
Mohammed A
MA
Sack
David A
DA
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D011159:Population Surveillance; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate