Point-of-Admission Serum Electrolyte Profile of Children less than Five Years Old with Dehydration due to Acute Diarrhoea

Abstract

Background/Objective: Fluid, electrolytes and acid base disturbances are responsible for most deaths due to acute diarrhoea. The aim of this study is to describe the point-of-admission serum electrolyte profile of children with dehydration due to acute diarrhoea. Methods: In this cross-sectional study, the serum electrolyte levels of 185 children with dehydration due to acute diarrhoea were assessed at the point of admission at the Diarrhoea Treatment and Training Unit of the University of Benin Teaching Hospital. The age of the study population ranged from 29 days to 59 months. Results: Out of a total of 185 subjects, 30 (16.2%), 114 (61.6%), and 41 (22.2%) had severe, moderate and mild dehydration, respectively. In addition, hyponatraemic dehydration was the most common type of dehydration, accounting for 60.5% of cases. Metabolic acidosis and hypokalaemia occurred in 59.5% and 44.3% of cases, respectively. Only the serum bicarbonate level was significantly affected by degree of dehydration (p = 0.001). Age of more than 12 months and presence of vomiting were significantly associated with hyponatraemia (p = 0.005 & p = 0.02), while age of less than or equal 12 months and absence of vomiting were associated with metabolic acidosis (p = 0.04 & p = 0.03). Conclusion: The degree of dehydration appears to be a good predictor of the occurrence of metabolic acidosis while age is a risk factor for hyponatraemia and metabolic acidosis.

Prevalensi Gangguan Elektrolit Serum pada Pasien Diare dengan Dehidrasi Usia Kurang dari 5 Tahun di RSUP Dr. Sardjito Tahun 2013-2016

“…Hal tersebut terjadi karena anak memiliki perbedaan fisiologis mayor dengan orang dewasa, seperti total luas permukaan tubuh, struktur ginjal dan sistem endokrin yang belum matur, serta level metabolik anak lebih tinggi. 4 Penelitian Chambuso dkk, 14 di Mwanza, Tanzania, melaporkan bahwa prevalensi defisiensi elektrolit pada pasien diare usia kurang dari 5 tahun adalah 54,5%. 14 Sementara di Nigeria, gangguan elektrolit dan asam basa ditemukan 165 (89,2%) anak dari 185 pasien.…”

“…14 Sementara di Nigeria, gangguan elektrolit dan asam basa ditemukan 165 (89,2%) anak dari 185 pasien. 4 Ditemukan 30 (17,3%) pasien hipokalsemia yang merupakan gangguan elektrolit terbanyak. Sembilan puluh sembilan persen kalsium total tubuh tersimpan dalam tulang dan homeostasis kalsium diregulasi oleh hormon paratiroid, kalsitonin, dan vitamin D. Kalsium penting untuk banyak fungsi tubuh, termasuk metabolisme tulang, aktivitas neuromuskular, konduksi elektrik jantung dan otot polos, koagulasi, serta fungsi eksokrin dan endokrin.…”

“…Penelitian yang dilakukan pada 185 anak yang mengalami diare akut dengan dehidrasi menunjukkan bahwa 109 (58,9%) anak di antaranya mengalami demam. 4 Non inflammatory diare bersifat cair tanpa darah ataupun mukus dan biasanya tidak disertai dengan demam. Diare ini sebagian besar disebabkan oleh virus, khususnya rotavirus, dan sering melibatkan usus halus tanpa adanya kerusakan mukosa.…”

“…3 Kasus diare akut di dunia diperkirakan 1,7 milyar, mengakibatkan 700.000 kematian setiap tahunnya pada anak di bawah usia 5 tahun. 4 Di negara berkembang, penyakit diare merupakan penyebab dari 17,5%-21% kematian pada balita, setara dengan 1,5 juta kematian per tahun. Dari seluruh anak yang meninggal karena diare, 78% terjadi di Afrika dan Asia Tenggara.…”

Environmental factors associated with diarrhoea among under-five children attending at Muhimbili National Hospital, Tanzania: a descriptive cross sectional study

“…The study conducted by Bado,Susuman (2) identi ed that there is a link between diarrhoea disease among under ve children and poor standard of living, poor general hygiene and inability to have safe water for drinking The effects that may result from diarrhoea include electrolytes and uid imbalance, disturbance in acid and base regulation. Children suffering from severe diarrhoea they are at risk of getting electrolyte imbalance like hypokalaemia and dehydration which is the most cause of death if it is not treated immediately (3). The common ways of preventing diarrhoea disease are by applying the ways target in interfering of faecal oral transmissions pathways, commonly refers as ve "F" ( uids, elds, ies, nger and food) such using clean and safe water, sanitation, hygiene good preparation of food which all (4).…”