title: Diarrhoea in slum children: observation from a large diarrhoeal disease hospital in Dhaka, Bangladesh.
abstract: OBJECTIVE
  To determine and compare socio-demographic, nutritional and clinical characteristics of children under five with diarrhoea living in slums with those of children who do not live in slums of Dhaka, Bangladesh.
  
  
  METHODS
  From 1993 to 2012, a total of 28 948 under fives children with diarrhoea attended the Dhaka Hospital of icddr,b. Data were extracted from the hospital-based Diarrhoea Disease Surveillance System, which comprised 17 548 under fives children from slum and non-slum areas of the city.
  
  
  RESULTS
  Maternal illiteracy [aOR = 1.57; 95% confidence interval (1.36, 1.81), P-value <0.001], paternal illiteracy [1.37 (1.21, 1.56) <0.001], mother's employment [1.59 (1.37, 1.85) <0.001], consumption of untreated water [2.73 (2.26, 3.30) <0.001], use of non-sanitary toilets [3.48 (3.09, 3.93) <0.001], 1st wealth quintile background [3.32 (2.88, 3.84) <0.001], presence of fever [1.14 (1.00, 1.29) 0.047], some or severe dehydration [1.21 (1.06, 1.40) 0.007], stunting [1.14 (1.01, 1.29) 0.030] and infection with Vibrio cholerae [1.21 (1.01, 1.45) 0.039] were significantly associated with slum-dwelling children after controlling for co-variates. Measles immunisation [0.52 (0.47, 0.59) P < 0.001] and vitamin A supplementation rates [0.36 (0.31, 0.41) P < 0.001] amongst children 12-59 months were lower for slum dwellers than other children in univarate analysis only.
  
  
  CONCLUSIONS
  Slum-dwelling children are more malnourished, have lower immunisation rates (measles vaccination and vitamin A supplementation) and higher rates of measles, are more susceptible to diarrhoeal illness due to V. cholerae and suffer from severe dehydration more often than children from non-slum areas. Improved health and nutrition strategies should give priority to children living in urban slums.
authors.affiliation: International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh; Department of Clinical Trial and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Farzana
authors.initials: F
authors.lastname: Ferdous
authors.forename: Sumon Kumar
authors.initials: SK
authors.lastname: Das
authors.forename: Shahnawaz
authors.initials: S
authors.lastname: Ahmed
authors.forename: Fahmida Dil
authors.initials: FD
authors.lastname: Farzana
authors.forename: Mohammad Abdul
authors.initials: MA
authors.lastname: Malek
authors.forename: Jui
authors.initials: J
authors.lastname: Das
authors.forename: Jonathan Ross
authors.initials: JR
authors.lastname: Latham
authors.forename: Abu Syed Golam
authors.initials: AS
authors.lastname: Faruque
authors.forename: Mohammod Jobayer
authors.initials: MJ
authors.lastname: Chisti
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D002675:Child, Preschool; D003681:Dehydration / Q000150:complications; D003967:Diarrhea / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D004522:Educational Status; D005260:Female; D005334:Fever / Q000209:etiology; D006130:Growth Disorders / Q000150:complications; D006761:Hospitals; D006801:Humans; D007114:Immunization; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008457:Measles / Q000453:epidemiology / Q000276:immunology; D010290:Parents; D011204:Poverty Areas; D012499:Sanitation; D014505:Urban Population; D014735:Vibrio Infections / Q000150:complications / Q000382:microbiology; D014734:Vibrio cholerae; D014801:Vitamin A / Q000008:administration & dosage / Q000276:immunology; D014881:Water Supply
chemical_list: D014801:Vitamin A
keywords: Bangladesh; bidonville; children; diarrea; diarrhoea; diarrhée; enfants; niños; slum; tugurios; urbain; urban; urbana