title: Characteristics of severely malnourished under-five children hospitalized with diarrhoea, and their policy implications.
abstract: OBJECTIVE
  Identify clinical and nutritional features, and complications among severely malnourished, under-five children in an urban diarrhoeal disease facility in Bangladesh.
  
  
  METHODS
  For this case-control design, children of both sexes, aged 0-59 months were studied. Severely (< -3 z-score) underweight, stunted or wasted constituted cases and those with better nutritional status (z-score > or = -3) constituted controls.
  
  
  RESULTS
  During 2000-2005, of the total 6881 children, 1103 (16%) were severely underweight, 705 (11%) severely stunted and 217 (3%) severely wasted. In logistic regression analysis, severely underweight children were more likely to be older than 11 months (OR 3.7, 95% CI 3.1-4.3, p < 0.001), non-breastfed (OR 1.5, 95% CI 1.3-1.8, p < 0.001), have illiterate mothers (OR 2.6, 95% CI 2.2-3.0, p < 0.001), non-sanitary toilet (OR 1.4, 95% CI 1.2-1.6, p < 0.001), a history of measles in preceding 6 months (OR 1.7, 95% CI 1.3-2.4, p = 0.001), dehydrating diarrhoea (OR 1.9, 95% CI 1.6-2.2, p < 0.001), abnormal findings in lung auscultation (OR 1.7, 95% CI 1.3-2.3, p < 0.001) and require hospitalization > or = 48 h (OR 2.2, 95% CI 1.8-2.5, p < 0.001).
  
  
  CONCLUSIONS
  There thus is a need to incorporate appropriate, cost-effective and sustainable preventive strategies and improved management policies in the health systems as well as in social support systems in Bangladesh.
authors.affiliation: Clinical Sciences Division, ICDDR,B: Centre for Health and Population Research, GPO Box 128, Dhaka 1000, Bangladesh.
authors.forename: Mohammod J
authors.initials: MJ
authors.lastname: Chisti
authors.forename: Mohammad I
authors.initials: MI
authors.lastname: Hossain
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Malek
authors.forename: Abu S G
authors.initials: AS
authors.lastname: Faruque
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Salam
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D015362:Child Nutrition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002675:Child, Preschool; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology*; D015999:Multivariate Analysis; D015596:Nutrition Assessment