Nutrition and Infection Field Study in Guatemalan Villages, 1959–1964

Gordon, John E.; Ascoli, Werner; Mata, Leónardo; Guzmán, Miguel A.; Scrimshaw, Nevin S.

doi:10.1080/00039896.1968.10665082

Cited by 34 publications

(5 citation statements)

References 21 publications

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“…The idea of a normal diarrhea not needing treatment is widespread in this community, but it may lead to serious misjudgment of the clinical status of the child and should be discouraged. [15][16][17] That ORS sachets should be available at home is generally accepted, [18][19][20][21] although this idea has been disputed. 22 The present study indicates that presence of ORS in the home did not lead to less consultations, and prior use of ORS was associated with increased likelihood of being brought in for consultation.…”

Section: Discussionmentioning

confidence: 99%

Management of childhood diarrhea and use of oral rehydration salts in a suburban West African community.

Sodemann

Jakobsen²,

Mølbak³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. In a household survey in Guinea-Bissau, 319 episodes of diarrhea in children were followed by interviews every second day with the aim of investigating perceived morbidity and subsequent actions taken. The majority of the mothers had good knowledge of oral rehydration salts (ORS). However, only 58% of the episodes were treated with ORS and the amount given was insufficient. Mothers with no knowledge of ORS did not use it during the observed attack of diarrhea regardless of contact with a health center, which suggests that maternal knowledge is an important determinant of whether health personnel provide ORS. Children with diarrhea considered to be caused by teething were less likely to receive ORS in the acute phase (risk ratio ϭ 0.6, 95% confidence interval [CI] ϭ 0.5-0.9). Univariate analyses showed that the use of ORS was related to number of reported symptoms, the mother being the care taker, consultations, previous use of ORS, good knowledge of ORS, and having ORS sachets at home. Multivariate Cox regression analyses showed that the presence of ORS sachets at home at the onset of diarrhea was the strongest predictor of use (hazard ratio ϭ 3.3, 95% CI ϭ 1.9-3.6). Improved health education should focus more on the quantity of ORS needed, early signs of dehydration, treatment of teething diarrhea, and breast feeding, and address mothers who have no prior knowledge of ORS. Management of diarrhea may be improved by a more liberal distribution of ORS sachets.

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Section: Discussionmentioning

confidence: 99%

Management of childhood diarrhea and use of oral rehydration salts in a suburban West African community.

Sodemann

Jakobsen²,

Mølbak³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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“…The association of recurrent infections on nutrition and growth during childhood is well described. The classic studies in rural Guatemala by Scrimshaw et al (9)(10)(11)(12)(13)(14)(15) established the important relationship among infections, nutrition and growth. This relationship was also vividly described by Mata et al (16,17) in follow-up studies that demonstrated the relationship of recurrent infections with growth failure.…”

Section: Biological Plausibility Of the Effect Of Infections On Growthmentioning

confidence: 99%

Effect of Infections and Environmental Factors on Growth and Nutritional Status in Developing Countries

Bhutta

2006

J. pediatr. gastroenterol. nutr.

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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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“…A similar proportion of cases extending beyond 2 weeks (3.4%) was noted in a prospective study of children less than 2 years of age in Indonesia (12). Even higher rates have been reported from Guatamala (13) and Bangladesh (14). In one community in the latter study, 23% of all diarrheal illnesses lasted more than 2 weeks.…”

Section: Discussionmentioning

confidence: 67%

Prolonged and Recurring Diarrhea in the Northeast of Brazil

McAuliffe,

Shields,

de Sousa

et al. 1986

J. pediatr. gastroenterol. nutr.

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SummaryFrom prospective daily surveillance of diarrhea in a poor rural area of northeastern Brazil, this study of prolonged diarrheal episodes identified the 3% of diarrheal episodes that lasted 15 days or longer. These episodes also defined a subpopulation of children who spent over 16% of their days with diarrhea. Such children warrant further attention in an attempt to define potentially treatable causes as well as to assure appropriate nutritional support. There was no single season for these prolonged illnesses, but they appeared to involve both the wet, slightly warmer season of peak enterotoxigenic Escherichia coli diarrhea as well as the dry, slightly cooler season of peak rotaviral infections. Limited etiologic data support this idea that multiple pathogens are found, often in combination with each other, that may work together to contribute to the important problem of chronic diarrhea. Future studies should focus attention on further defining risk factors, mechanisms, and appropriate therapy for the subset of children who experience prolonged diarrhea in this type of setting.

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Nutrition and Infection Field Study in Guatemalan Villages, 1959–1964

Cited by 34 publications

References 21 publications

Management of childhood diarrhea and use of oral rehydration salts in a suburban West African community.

Management of childhood diarrhea and use of oral rehydration salts in a suburban West African community.

Effect of Infections and Environmental Factors on Growth and Nutritional Status in Developing Countries

Prolonged and Recurring Diarrhea in the Northeast of Brazil

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