Epidemiological and clinical profiles of acute invasive diarrhoea with special reference to mucoid episodes: a rural community-based longitudinal study

Gupta, DN; Sircar, B K; Sengupta, P. G.; Ghosh, Subrata; Banu, M; Mondal, Sudeshna; Saha, Dhira Rani; De, S. P.; Sikdar, S. N.; Manna, Byomkesh; Saha, Nayanendu

doi:10.1016/s0035-9203(96)90315-6

Cited by 10 publications

(13 citation statements)

References 7 publications

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“…In this study, diarrhea was defined by the passing of three or more loose stools in a 24-hour period as detected by the mother or the responsible caregiver, similar to what has been suggested by the WHO [12] and adopted in many studies [13][14][15][16][17][18][19][20], but contrasting to others who have defined diarrhea as at least four dejections per day [21][22][23] or according to parental definition [10,[24][25][26]. Most recent studies consider that the passing of three or more unformed stools or any number with the presence of blood over a 24-hour period define diarrhea satisfactorily on adults and children older than two years, while to define an episode of diarrhea, the illness has to be preceded and followed by at least three days free of diarrhea [6,13,14,[27][28][29].…”

Section: Discussionsupporting

confidence: 71%

Incidence of diarrhea: poor parental recall ability

Melo¹,

Taddei²,

Diniz-Santos³

et al. 2007

Braz J Infect Dis

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Several methodological issues may have an impact on the incidence rates of childhood acute diarrhea reported by community-based studies. This study was performed to assess the impact of parental recall ability and definition of diarrhea on the estimate of incidence of acute diarrhea. Eighty-four children younger than 40 months were randomly selected and visited every other day for four weeks and the occurrence of diarrhea was registered. On the last day of the study, another visit was performed and the informants were inquired about the occurrence of diarrhea during the previous four weeks. Data gathered during the four weeks were compared to those obtained on the last visit. Additionally, the informants' definition of diarrhea was investigated and compared to the one adopted by this study. During the observation period, 33 children suffered diarrhea, but only 10 (30.3%) informants reported the occurrence of diarrhea. Although 42.4% of those informants reported that their children had been ill over that period, they did not report diarrhea. Further, 60.6% children who had diarrhea suffered at least one episode in the two weeks prior to the visitation. The same definition of diarrhea used in this study was adopted by 52.1% of the informants inquired. Parental recall is an unreliable method to estimate the incidence of diarrhea and studies with a short interval between the visits should be necessary to correctly evaluate this important health problem. Moreover, assessing the informants' own definition of diarrhea is a significant contribution to the interpretation of the results.

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Section: Discussionsupporting

confidence: 71%

Incidence of diarrhea: poor parental recall ability

Melo¹,

Taddei²,

Diniz-Santos³

et al. 2007

Braz J Infect Dis

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“…The systematic literature search yielded 5708 titles for children (Figure 1), of which we identified 41 and 27 studies for inclusion in the analysis of duration [8-48] and severity [8,9,16,19,21,22,25,26,36,39,43,45,49-63], respectively. All included studies reported data on children 0-59 months of age.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of diarrhea duration and severity in children and adults in low- and middle-income countries

2012

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BackgroundDiarrhea is a leading cause of morbidity and mortality globally; yet the overall burden of diarrhea in terms of duration and severity has not been quantified. As improvements in treatment lead to decreases in diarrhea mortality, it is important to understand the substantial impact of diarrhea morbidity on disability among children and adults worldwide.MethodsWe conducted a systematic review to generate estimates of duration and severity outcomes for individuals 0-59 mos, 5-15 yrs, and ≥ 16 yrs, and for 3 severity indexes: mild, moderate, and severe.ResultsWe estimate that among children under-five, 64.8% of diarrheal episodes are mild, 34.7% are moderate, and 0.5% are severe. On average, mild episodes last 4.3 days, and severe episodes last 8.4 days and cause dehydration in 84.6% of cases. We estimate that among older children and adults, 95% of episodes are mild; 4.95% are moderate; and 0.05% are severe. Among individuals ≥ 16 yrs, severe episodes typically last 2.6 days and cause dehydration in 92.8% of cases.ConclusionsModerate and severe episodes constitute a substantial portion of the total envelope of diarrhea among children under-five (35.2%; about 588 million episodes). Among older children and adults, moderate and severe episodes account for a much smaller proportion of the total envelope of diarrhea (5%), but the absolute number of such episodes is noteworthy (about 21.5 million episodes among individuals ≥ 16 yrs). Hence, the global burden of diarrhea consists of significant morbidity, extending beyond episodes progressing to death.

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“…This method differs from other studies which collected data on home visits once in a month [21,22], fortnightly [15,20], and once [4,8,14], twice [23][24][25] or three times [26,27] in a week. To our knowledge, the study from Haque et al [12] is the only one with the same methodology to ours published to date.…”

Section: Discussionmentioning

confidence: 99%

Incidence of diarrhea in children living in urban slums in Salvador, Brazil

Melo¹,

Taddei²,

Diniz-Santos³

et al. 2008

Braz J Infect Dis

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Diarrhea remains a major health issue in developing countries, with high morbidity and mortality rates. Determining the incidence of acute diarrhea in children and its associated factors is crucial to the planning of preventive approaches. The objective of this study was to determine the incidence of diarrhea and to assess some relevant associated factors to it in children younger than 40 months living in two slums of Salvador, Brazil. This is the first prospective cohort, community-based study that was performed in two periurban slums of Salvador, Brazil. Eightyfour children younger than 40 months were randomly selected and visited every other day for one year. The chisquare test was used to evaluate the occurrence of diarrhea and its associated factors. During the surveillance period, 232 diarrhea episodes were identified, resulting in an incidence rate of 2.8 episodes/child/year. In average (mean value of 84 children),each child suffered 11.1 days of diarrhea per year, yielding an average duration of 3.9 days per episode. The highest incidence rates were found among children under one year old. Early weaning, male sex, malnutrition, having a mother younger than 25 years or who considered her child malnourished, missed immunizations and previous pneumonia were associated factors for suffering diarrheal episodes. The rates of incidence and duration of diarrhea that we found are in accordance to those reported by others. Additionally, our results reinforce the importance of environmental and health-related associated factors to the onset of diarrhea.

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Epidemiological and clinical profiles of acute invasive diarrhoea with special reference to mucoid episodes: a rural community-based longitudinal study

Cited by 10 publications

References 7 publications

Incidence of diarrhea: poor parental recall ability

Incidence of diarrhea: poor parental recall ability

Systematic review of diarrhea duration and severity in children and adults in low- and middle-income countries

Incidence of diarrhea in children living in urban slums in Salvador, Brazil

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