Some aspects of persistent diarrhoea in children seen at Mulago Hospital - A case control study

ABSTRACT

Diarrhoeal diseases continue to be a major cause of children morbidity and mortality in developing countries. Most mortality is due to dehydration following acute diarrhoea. However; with the advent of Oral Rehydration therapy; there has been considerable success in the treatment of dehydration due to acute diarrhoeal diseases. A sizeable number of children who survive the acute episode; develop a prolonged episode of diarrhoea that lasts more than fourteen days. This is referred to as persistent diarrhoea and is associated with higher mortality rates. To date few studies on persistent diarrhoea have been done. It was for this reason that a study to find out and explain some risk factors for persistent diarrhoea; and to describe some enteric pathogens associated with persistent diarrhoea was done. a case control study was carried out among 140 children under 5 years of age attending clinics in Mulago Hospital. Clinical assessment and anthropometric measurements were used to assess the nutritional state of the children. The peak of persistent diarrhoea was in children aged 5-11 months (47.9) and there was no sex difference. Risk factors for in this study included lack of breastfeeding; cessation of breastfeeding during diarrhoea; immunisation status and evidence of wasting at the time of presentation whereas 81of children under 2 years of age with persistent diarrhoea were still feeding. Furthermore; more children with persistent diarrhoea (38.3) were given lcoal herbs as treatment for diarrhoea compared with 17.4of those with acute diarrhoea suggesting that the longer an episode of diarrhoea is; the more likely is for a child to receive more types medications. clinical features encountered more frequently in children with persistent diarrhoea included wasting; pallor; angular stomatitis and skin changes while more children with acute diarrhoea were severely dehydrated at the time of admission. The findings of this study; suggest that breast feeding should be encouraged during and after the diarrhoeal episode and its protective role against the development of diarrhoea; emphasised the use of local herbs should be discouraged