Prolonged and persistent diarrhoea is not restricted to children with acute malnutrition: An observational study in Ethiopia

TY - JOUR

T1 - Prolonged and persistent diarrhoea is not restricted to children with acute malnutrition

T2 - An observational study in Ethiopia

AU - Zangenberg, Mike

AU - Johansen, Øystein H

AU - Abdissa, Alemseged

AU - Eshetu, Beza

AU - Kurtzhals, Jørgen

AU - Friis, Henrik

AU - Sommerfelt, Halvor

AU - Langeland, Nina

AU - Hanevik, Kurt

N1 - CURIS 2019 NEXS 268 This article is protected by copyright. All rights reserved.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Objectives: To assess the prevalence of prolonged and persistent diarrhoea, to estimate their co-occurrence with acute malnutrition and association with demographic and clinical factors. Methods: Case–control study where cases were children under 5 years of age with diarrhoea and controls were children without diarrhoea, frequency-matched weekly by age and district of residency. Controls for cases 0–11 months were recruited from vaccination rooms, and controls for cases 12–59 months were recruited by house visits using random locations in the catchment area of the study sites. Data were analysed by mixed model logistic regression. Results: We enrolled 1134 cases and 946 controls. Among the cases, 967 (85%) had acute diarrhoea (AD), 129 (11%) had ProD and 36 (3.2%) had PD. More cases had acute malnutrition at enrolment (17% vs. 4%, P < 0.0001) and more were born prematurely (5.7% vs. 1.8%, P < 0.0001) than controls. About 75% of ProPD cases did not have acute malnutrition. Cases with AD and ProPD had different symptomatology, even beyond illness duration. Conclusions: ProPD is common among children presenting with diarrhoea and is not confined to children with acute malnutrition. There is an urgent need for studies assessing causes of ProPD with and without acute malnutrition to develop treatment guidelines for these conditions.

AB - Objectives: To assess the prevalence of prolonged and persistent diarrhoea, to estimate their co-occurrence with acute malnutrition and association with demographic and clinical factors. Methods: Case–control study where cases were children under 5 years of age with diarrhoea and controls were children without diarrhoea, frequency-matched weekly by age and district of residency. Controls for cases 0–11 months were recruited from vaccination rooms, and controls for cases 12–59 months were recruited by house visits using random locations in the catchment area of the study sites. Data were analysed by mixed model logistic regression. Results: We enrolled 1134 cases and 946 controls. Among the cases, 967 (85%) had acute diarrhoea (AD), 129 (11%) had ProD and 36 (3.2%) had PD. More cases had acute malnutrition at enrolment (17% vs. 4%, P < 0.0001) and more were born prematurely (5.7% vs. 1.8%, P < 0.0001) than controls. About 75% of ProPD cases did not have acute malnutrition. Cases with AD and ProPD had different symptomatology, even beyond illness duration. Conclusions: ProPD is common among children presenting with diarrhoea and is not confined to children with acute malnutrition. There is an urgent need for studies assessing causes of ProPD with and without acute malnutrition to develop treatment guidelines for these conditions.

KW - Faculty of Science

KW - Prolonged diarrhoea

KW - Persistent diarrhoea

KW - Moderate acute malnutrition

KW - Severe acute malnutrition

U2 - 10.1111/tmi.13291

DO - 10.1111/tmi.13291

M3 - Journal article

C2 - 31325406

SN - 1360-2276

VL - 24

SP - 1088

EP - 1097

JO - Tropical Medicine & International Health

JF - Tropical Medicine & International Health

IS - 9

ER -