Association between diarrheal duration and nutritional decline: Implications for an empirically validated definition of persistent diarrhea

Abstract

In an empiric approach to develop the definition of persistent diarrhea, we evaluated the relationship between diarrheal duration and risk of ensuing clinically significant decline in nutritional status, in a cohort of 395 children < 24 mo. Weights were obtained at the onset of diarrhea (wt I) and after three months interval (wt II). The occurrence of an adverse outcome (AO) was defined as a decline of -- 5% in NCHS weight for age (% WFA) between weights I and II or death in this interval. The risk of AO was similar for episodes of / or > 7 days while it was substantially higher in episodes with > 14 days duration (45%) than for shorter duration episodes, relative risk (RR) = 2.5 (p < 0.001). Relative risk remained similar for duration thresholds of 21 (2.3) and 28 days (2.6). As episode durations greater than 14 days are associated with substantial elevation of the risk of clinically cogent sequelae, such episodes may be termed 'persistent' at least in terms of poor prognostic expectations.

The Role of Zinc and Vitamin A in Persistent Diarrhea Among Infants and Young Children

“…The practical implications of these findings are that in deficient populations, administration of 10 to 20 mg elemental zinc daily to young children early in acute diarrhea, as an adjunct to fluid therapy, is likely to shorten duration of the episode and to reduce substantially the risk of persistent diarrhea. That persistent diarrhea can be prevented is very important in designing treatment programs, because of the high rate of associated fatality (38) and the adverse nutritional impact (39) on patients of protracted diarrhea, and because of families' satisfaction with a treatment approach that relies primarily on oral rehydration and discourages antimicrobial therapy.…”

Relation between Behavioral Factors, Malnutrition and Persistent Diarrhea in Children Under Two Years of Age. A Hospital Study

“…The hands of the mother and the child should be washed before making and offering the food for the child. The mother should be advised to breast feed her baby for 2 years to reduce the risk of diarrhea (7) Malnutrition especially sever one increase the duration of diarrhea and leads to persistent diarrhea (8) .Under weight children (<80%) of their expected weight and marsmus (< 60%) of expected weight, Kwashiorkor (60%-80%) of the expected weight with edema all found to be associated with persistent diarrhea (8) Infectious diseases like measles, chicken pox are associated with persistent diarrhea.…”