title: Risk factors for extended duration of acute diarrhea in young children.
abstract: OBJECTIVE
  We sought to identify predictors of extended duration of diarrhea in young children, which contributes substantially to the nearly 1 1/2 million annual diarrheal deaths globally.
  
  
  METHODS
  We followed 6-35 month old Nepalese children enrolled in the placebo-arm of a randomized controlled trial with 391 episodes of acute diarrhea from the day they were diagnosed until cessation of the episode. Using multiple logistic regression analysis, we identified independent risk factors for having diarrhea for more than 7 days after diagnosis.
  
  
  RESULTS
  Infants had a 17 (95% CI 3.5, 83)-fold and toddlers (12 to 23 month olds) a 9.9 (95% CI 2.1, 47)-fold higher odds of having such illness duration compared to the older children. Not being breastfed was associated with a 9.3 (95% CI 2.4, 35.7)-fold increase in the odds for this outcome. The odds also increased with increasing stool frequency. Furthermore, having diarrhea in the monsoon season also increased the risk of prolonged illness.
  
  
  CONCLUSIONS
  We found that high stool frequency, not being breastfed, young age and acquiring diarrhea in the rainy season were risk factors for prolonged diarrhea. In populations such as ours, breastfeeding may be the most important modifiable risk factor for extended duration of diarrhea.
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway. tors@me.com
authors.forename: Tor A
authors.initials: TA
authors.lastname: Strand
authors.forename: Pushpa R
authors.initials: PR
authors.lastname: Sharma
authors.forename: Håkon K
authors.initials: HK
authors.lastname: Gjessing
authors.forename: Manjeswori
authors.initials: M
authors.lastname: Ulak
authors.forename: Ram K
authors.initials: RK
authors.lastname: Chandyo
authors.forename: Ramesh K
authors.initials: RK
authors.lastname: Adhikari
authors.forename: Halvor
authors.initials: H
authors.lastname: Sommerfelt
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D001942:Breast Feeding; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009390:Nepal / Q000453:epidemiology; D012307:Risk Factors; D012621:Seasons