title: Risk factors for predicting diarrheal duration and morbidity in children with acute diarrhea.
abstract: OBJECTIVE
  To identify baseline risk factors for prolonged diarrheal duration and subsequent complications in children aged 6 to 59 mo with acute diarrhea who participated in a micronutrient clinical trial in a tertiary care hospital.
  
  
  METHODS
  The adjusted odds ratio or incidence risk ratios (IRR) of the baseline variables for prolongation of diarrheal duration (cox proportional hazard model), diarrhea >7 d (multiple logistic regressions), severe dehydration experienced after hospitalization (poisson regression models) was estimated.
  
  
  RESULTS
  Fever (OR 1.10, 95% CI 1.02-1.19, p = 0.02), dehydration (OR 1.32, 95% CI 1.10-1.59, p = 0.003), dysentery (OR 1.41 95% CI 1.09-1.82, p = 0.008), those who received medications (OR 1.19, 95% CI 1.03-1.39, p = 0.02), and weight for age Z-score ≤2 (OR 1.25, 95% CI 1.07-1.46, p = 0.004) were at a greater risk of prolonged diarrhea. Diarrhea >7 d was associated with younger age (OR 1.08, 95% CI 1.03-1.14, p = 0.003), female child (OR 2.33, 95% CI 1.19-4.55, p = 0.013), diarrheal duration before enrolment (OR 1.06, 95% CI 1.04-1.09, p < 0.001), fever (OR 1.7, 95% CI 1.23-2.49, p = 0.002) and the weight for age Z-score ≤2 (OR 4.32, 95% CI 2.03-9.16, p < 0.001). Severe dehydration after hospitalization was associated with dehydration at baseline (OR 6.7, 95% CI 2-3.0, p < 0.001), incomplete immunization (OR 3.33, 95% CI 1.5-7.69, p < 0.001), failure to receive any medication(OR 3.03, 95% CI 1.26-7.14, p = 0.01).
  
  
  CONCLUSIONS
  Few studies assess risk factors for diarrheal morbidity prospectively. The present study showed that children of acute diarrhea with above risk factors need stricter monitoring for complications to reduce diarrheal mortality.
authors.affiliation: Department of Pediatrics, Indira Gandhi Government Medical College, Nagpur, India. dr_apatel@yahoo.com
authors.forename: Archana B
authors.initials: AB
authors.lastname: Patel
authors.forename: Ronithung
authors.initials: R
authors.lastname: Ovung
authors.forename: Neetu B
authors.initials: NB
authors.lastname: Badhoniya
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dibley
mesh_terms: D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003289:Convalescence; D003300:Copper / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003681:Dehydration / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D003906:Developing Countries; D003967:Diarrhea / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D003968:Diarrhea, Infantile / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D012307:Risk Factors; D012923:Social Class; D015032:Zinc / Q000627:therapeutic use
chemical_list: D003300:Copper; D015032:Zinc