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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To identify the prognostic indicators and risk factors for increased duration of acute diarrhoea and for occurrence of persistent diarrhoea (i.e. acute episodes lasting longer than 14 days) in children under three years, a systematic sample (3690) of patients attending a large treatment centre in Bangladesh was analysed using multiple regression, logistic regression and stratified (Mantel-Haenszel) analysis. Significant prognostic indicators or risk factors for increase in duration of acute diarrhoea, after adjusting for confounders, include bloody or mucoid diarrhoea, concomitant signs of chest infection, presence of vitamin A deficiency signs, decreased weight for age, routine use of contaminated surface water, lack of breastfeeding and increasing age; presence of rotavirus or enterotoxigenic Escherichia coli or Vibrio cholerae 01 in stool had negative association. In logistic regression and stratified analysis these factors, except for lack of breastfeeding and age, were also found to be risk factors or prognostic indicators of persistent diarrhoea. Policy implications of these findings for programmes to reduce morbidity and mortality from persistent diarrhoea include development of effective vaccines against dysentery-causing Shigella, programmes to prevent vitamin A deficiency, protein energy malnutrition and acute respiratory infections in children, and long-term programmes to provide clean water for all day-to-day needs.
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PMID:Prognostic indicators and risk factors for increased duration of acute diarrhoea and for persistent diarrhoea in children. 180 Apr 5

With a systematically sampled population of children aged under 5 attending this centre for diarrhoeal disease research during 1983-5 a retrospective analysis of persistent diarrhoea (defined as greater than 14 days' duration) was performed to identify the possible risk factors for this syndrome. Of the 4155 children included in the analysis, 410 (10%) gave a history of persistent diarrhoea. A comparison with children with acute diarrhoea matched for age showed that 11 factors were correlated with persistent diarrhoea, and strongly associated factors were stools with blood or mucus, or both, lower respiratory tract infection, malnutrition, vitamin A deficiency, and antibiotic use before presentation. The peak age was 2 years, and there was no sex difference. Deaths occurred more often in the group with persistent diarrhoea. Although Shigella spp, Campylobacter jejuni, and Giardia lamblia were frequently identified, their rates of isolation were not significantly higher among patients with persistent diarrhoea. No seasonal variation was observed in the rates of persistent diarrhoea. Although the introduction of family food to the diet was associated with higher rates, this factor was difficult to separate from the age dependent risks.
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PMID:Risk factors for persistent diarrhoea. 314 3

75 patients, less than one year old, admitted in our Hospital, from January 1991 to april 1992 were divided in three groups: Group I: 25 controls, group II 25 patients with acute diarrhoea and group III 25 patients with persistent diarrhoea. The serological status of vitamin A was evaluated and classified as normal, not severe deficiency and severe deficiency. It was demonstrated that vitamin A deficiency is a risk factor for persistent diarrhoea.
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PMID:[Serum levels of vitamin A and their relation with acute and persistent diarrhea]. 770 11

Clinical vitamin A deficiency as manifested by mild xerophthalmia predisposes to increased diarrhea and respiratory morbidity. The authors therefore used a double blind randomized placebo controlled field trial to assess the impact of vitamin A supplementation in an urban slum of New Delhi, India, on morbidity from acute respiratory tract infections and diarrhea during a three-month period. 900 children aged 12-60 months attending a local health facility for acute diarrhea of less than seven days duration were randomly allocated to receive either vitamin A 200,000 IU or a placebo. The study found the incidence and average number of days with acute lower respiratory tract infections to be similar in both the supplementation and placebo groups. The incidence of measles among those aged 23 months or less, however, was reduced significantly in the supplementation group. The incidence of diarrhea was also similar in the two groups, although there was a 36% reduction in the mean daily prevalence of diarrhea associated with fever in the vitamin A supplemented children older than 23 months. The lack of impact upon acute lower respiratory tract related mortality after vitamin A supplementation has been seen in other trials.
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PMID:Impact of massive dose of vitamin A given to preschool children with acute diarrhoea on subsequent respiratory and diarrhoeal morbidity. 788 7

Effect of vitamin A supplementation on duration of diarrhea was evaluated in 108 cases between 6 months to 5 years of age suffering from acute diarrhea of less than 3 days duration and results were compared with equal number of age and sex matched controls having comparable feeding pattern, nutritional and socio-economic status and clinical profile who did not receive vitamin A supplementation. There was no significant difference in the mean duration of diarrhea in cases who received vitamin A and the controls. However, on subgroup analysis of the study and control groups a significant (p = 0.009) beneficial effect of vitamin A supplementation was noticed in cases who had a pre-existing vitamin A deficiency with CIC stage 3/5 and above. Even though vitamin A supplementation in malnourished children did not significantly alter the duration of diarrhea, a beneficial effect was observed in children who had CIC state 3 and above in association with malnutrition (p = 0.025). Our results indicate that vitamin A supplementation does not significantly reduce the duration of a diarrheal episode. However, in children with pre-existing vitamin A deficiency particularly those who have associated malnutrition it may have a beneficial effect.
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PMID:A randomized controlled trial of vitamin A supplementation in acute diarrhea. 861 29

The prevalences of nightblindness and xerophthalmia were assessed in 400 children, aged 6-59 months, with acute diarrhoea in a rural community in Bangladesh. The prevalences of nightblindness, conjunctival xerosis, and Bitot's spot were 7.8%, 9.5%, and 2.7% respectively. Fifty-two percent of the children who complained of nightblindness had ocular signs of vitamin A deficiency compared to 9% of those without nightblindness (p < 0.000). The nightblindness was significantly higher among the male children, aged 24-59 months, who were dysenteric and undernourished, did not consume vitamin A-containing foods daily, and were not breastfed. The coverage of periodic administration of vitamin A capsule was inversely related to the prevalence of nightblindness. This finding was determined by logistic regression analysis of data indicating that a combination of male sex, history of dysentery, absence of periodic administration of vitamin A treatment, and daily intake of vitamin A-containing foods gave the best-fitted model with an overall prediction of 92.5% of being nightblind. The findings of the study suggest that mothers should be educated to observe their diarrhoeal children about development of nightblindness and to seek treatment for it. The locally-relevant nutrition education should also be offered to them.
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PMID:Vitamin A deficiency in children with acute diarrhoea: a community-based study in Bangladesh. 1105 69

Dr. Ayesha Molla, an ICDDR,B biochemist-nutritionist, was awarded a gold medal by the Bangladesh Women Scientists' Association and named Best Woman Scientist of the Year. She was honored for outstanding achievements in diarrhea/nutrition research especially in her classic studies on nutrient absorption during diarrhea. Her recent work has focused on the diarrhea/malnutrition mechanism in children. Her findings indicate that eating during acute diarrhea should be encouraged to reduce post-diarrhea malnutriton in vulnerable developing country children. In another study in collaboration with her husband, a pediatrician and gastroenterologist, it was found that diarrhea has a negligible effect on secretion of digestive enzymes which partially explains why significant digestion and absorption continue during diarrhea. Dr. Molla was also honored for related studies on the vitamin A/diarrhea/malnutrition mechanism. This is of immense importance in developing countries since repeated diarrheal infections in children aggravate malnutrition and lead to vitamin A deficiency blindness. Most blindness seems to be associated with or preceded by recurrent diarrheal infections. Dr. Molla found that water-soluble vitamin A administrated orally was associated with rapid improvement of deteriorating eye conditions. A brief outline of her background is given and her current work discussed. She is presently involved in seeking the best possible diet for children suffering from severe protein energy malnutrition (PEM). This problem results in coincident lack of varying proportions of protein and energy. Dr. Molla is attempting to determine the fastest, most tolerable, low cost, readily available and culturally acceptable diet. Maternal training in feeding practices will be provided. In collaboration with her husband, Dr. Molla is also studying the 2nd generation Oral Rehydration Solution (ORS). They are working to substitute rice or other staples for the traditional sugar in ORS.
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PMID:Bangladesh women scientists' association honours ICDDR,B scientist. 1227 28

Persistent diarrhea (PD) is 3 or more stools/day which lasts nonstop for 14 days. Some small intestine disorders impede its diagnosis. PD follows 3-20% of acute diarrhea cases. It is more difficult to treat than acute diarrhea and often brings about nutritional and metabolic complications, e.g., growth failure. Skin infection, systemic infection, and micronutrient deficiency often accompany PD so it is often referred to PD syndrome (PDS). PDS patients often have more frequent recurrences of diarrhea although not of PD. Deaths of hospitalized PDS patients range from 10-12% and most occur within the 1st 48 hours. Physicians should immediately follow the guidelines for managing sepsis dehydration, fever, hypoglycemia, and malnutrition when 1st treating a hospitalized PDS patient. They should then start broad spectrum antibiotics. Once stable, nutrition management can begin. This includes maintaining breast feeding or using expressed breast milk, a digestible balanced diet free of allergenic proteins, and additional micronutrients and vitamins. Upon arrival at home, the child should eat a high energy high protein diet. PDS most often occurs in young infants, e.g., peaking at 7 months in Bangladesh. Other risk factors include nonbreast feeding, recent antibiotic therapy, history of bloody diarrhea, vitamin A deficiency, and malnutrition. Giardia lamblia and aggregative, enterotoxigenic Escherichia coli in the stool have been associated with PDS, but have not yet been identified as causative agents. Scientists surmise that PDS is caused by an insult to the intestine which allows the passage of proteins, especially dietary proteins, through the mucosa thereby inducing a hypersensitive reaction which causes more mucosal damage. Excess bacterial growth plays a role in production of an irritant product which contributes to fluid loss.
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PMID:Persistent diarrhoea syndrome. 1231 13

Despite numerous advances and improvements in child health globally, malnutrition remains a major problem and underlies a significant proportion of child deaths. A large proportion of the hidden burden of malnutrition is represented by widespread single and multiple micronutrient deficiencies. A number of factors may influence micronutrient deficiencies in developing countries, including poor body stores at birth, dietary deficiencies and high intake of inhibitors of absorption such as phytates and increased losses from the body. Although the effects of poor intake and increased micronutrient demands are well described, the potential effects of acute and chronic infections on the body's micronutrient status are less well appreciated. Even more obscure is the potential effect of immunostimulation and intercurrent infections on the micronutrient distribution and homeostasis. The association therefore of relatively higher rates of micronutrient deficiencies with infectious diseases may be reflective of both increased predisposition to infections in deficient populations as well as a direct effect of the infection itself on micronutrient status indicators. Recently the association of increased micronutrient losses such as those of zinc and copper with acute diarrhea has been recognized and a net negative balance of zinc has been shown in zinc metabolic studies in children with persistent diarrhea. It is also recognized that children with shigellosis can lose a significant amount of vitamin A in the urine, thus further aggravating preexisting subclinical vitamin A deficiency. Given the epidemiological association between micronutrient deficiencies and diarrhea, supplementation strategies in endemic areas are logical. The growing body of evidence on the key role of zinc supplementation in accelerating recovery from diarrheal illnesses in developing countries supports its use in public health strategies.
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PMID:Effect of infections and environmental factors on growth and nutritional status in developing countries. 1720 74