Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey was conducted in 4 administrative regions of the Dominican Republic to determine the prevalence and incidence of acute diarrheal disease and acute respiratory infections and to increase knowledge of their epidemiological features and responses of the family to the conditions. An objective was to establish programs to reduce their occurrence. The study consisted of a retrospective survey of morbidity over the past 2 weeks or mortality over the past year from acute diarrhea or acute respiratory infection in a representative sample of children 5 years old. A cluster sampling method was used. 7322 children 5 were included. 59% had been sick in the 2 weeks preceding the survey. 94% of their illnesses corresponded to acute diarrheal disease or respiratory infection, with few regional differences. 27% of the children had had acute diarrheal disease in the 2 weeks preceding the survey, with a slightly higher frequency (30%) in urban areas. The incidence, or percentage of children with diarrhea on the survey date was 13%, ranging from 6% to 19% in different regions and with a greater prevalence in urban areas. The average duration of diarrheal episodes was 5 days, and the proportion of prolonged episodes lasting 15 or more days was 8%. 89% of the mothers had breast fed their children. 59% of urban and 51% of rural children were given less to eat during their diarrhea. Some form of oral rehydration was administered in 51% of cases. The use of iv feeding ranged from 3% to 12% in different regions and averaged 7% overall. Antidiarrheals or antibiotics were administered in 24% of cases. 65% of families sought medical assistance for the diarrhea. 5% of the children with diarrhea were hospitalized. Diarrhea mortality projected over the 1987 population age 0-4 suggested that around 6000 deaths associated with diarrhea occurred, of which about 5000 were in infants 1 year. 43% of all deaths were associated with diarrhea. The frequency of acute respiratory infection was 40%, ranging from 36% to 45% in different regions. The average duration was 7 days, with little regional or rural-urban variation. The calculated annual frequency of acute respiratory infection was 10 episodes/child, again with little geographic variation. Feeding of the child was decreased in 45% of cases. 49% of cases required medical attention and 58% received some form of treatment. 3% of cases required hospitalization. 26% of deaths in children 1 and 15% in those 1-4 were associated with acute respiratory infection. The annual projection of 50 days morbidity due to acute respiratory infection and 30 days due to diarrhea totals about 80 days of illness/child/year. Considering that feeding was reduced in 45% of children with acute respiratory infections and 55% with acute diarrhea, the potential effect on nutritional status is obvious.
Arch Domin Pediatr
PMID:[National Survey on Acute Diarrheal Disease and Acute Respiratory Infections, 1987]. 1228 89

A prospective study was conducted in late 1990 of 60 children aged 3-35 months to compare management of light to moderate dehydration from acute diarrhea using World Health Organization oral rehydration solution (ORS) or rice water. Rice water, the liquid obtained by draining rice after cooking, has the nutritional advantage of providing more calories during rehydration than does ORS and the osmolar advantage that its carbohydrates are released gradually in the intestine. 30 children were rehydrated with rice water and 30 with ORS. The rice water was prepared in the manner typical of mothers in the Dominican Republic as revealed by a recent survey. Mildly dehydrated patients were given 50 ml/kg of either rice water or ORS and those with moderate dehydration were given 100 ml/kg. Patients were monitored during the 4-6 hours of treatment and returned 24 hours later for evaluation. Serum sodium levels were measured on admission and after 4 hours of treatment. The two groups of infants were similar in age, sex, duration and severity of diarrhea, and degree of dehydration. The ORS group had 3.07 stools on average during treatment, significantly more than the 1.58 of the rice water group. The consistency more frequently remained watery in the ORS group. The ORS group gained more weight on average, 0.31 kg vs. 0.20 kg in the rice water group, but the difference was not statistically significant. Serum sodium tended to decline slightly in both groups, with the decline of 1.69 in the ORS group and 0.26 in the rice water group not differing significantly. The results suggest that rice water can be used along with solid foods in the maintenance phase after rehydration with ORS in cases of mild to moderate dehydration, but it should not be used alone as a rehydrating solution. Its use should be evaluated in infants under four months old and in severely malnourished children, who may absorb the carbohydrates too slowly to be effective in reducing fecal losses.
Arch Domin Pediatr
PMID:[Management of acute diarrheal disease with rice water]. 1229 May 46

Mortality from diarrheal diseases is most common in areas with high prevalence of caloric malnutrition. The considerable reduction of mortality from diarrhea following introduction of oral rehydration therapy has revealed the seriousness of persistent diarrhea with malnutrition. Persistent diarrhea is internationally defined as a diarrheal episode lasting 14 days or longer, generally accompanied by growth problems and protein calorie malnutrition. Persistent diarrhea is now considered a nutritional disease, generally occurring in low birth weight or malnourished children and itself a significant cause of protein calorie malnutrition. 10% of episodes of acute diarrhea are believed to evolve into persistent diarrhea, which accounts for 35% of deaths from diarrhea. Around 15% of episodes of persistent diarrhea are fatal. Several risk factors have been identified. Most patients are under one year old. Various studies have shown that protein calorie malnutrition retards repair of the damaged intestinal epithelium and prolongs diarrhea. Recent introduction of milk of animal origin is implicated in 30-40% of episodes of persistent diarrhea. Patients at risk have been shown to react abnormally to skin tests of antigens and to have recent histories of acute diarrhea or previous episodes of persistent diarrhea. Inconclusive studies implicate antimotilic drugs such as paregoric elixir and indiscriminate use of antibiotics as risk factors, but increased risk has been proven only with some antiparasitics. Patients with persistent diarrhea are deficient in vitamins A, B12, and folic acid, and in zinc and iron. Children under 6 months of age with persistent diarrhea should be hospitalized. Adequate feeding is the most important aspect of treatment. The objectives of nutritional treatment include temporary reduction of milk of animal origin, assurance of sufficient protein and calorie consumption, avoidance of foods aggravating the diarrhea, and correction of existing malnutrition.
Arch Domin Pediatr
PMID:[Persistent diarrhea]. 1229 May 53