How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

doi:10.5223/pghn.2012.15.4.229

Cited by 18 publications

(15 citation statements)

References 17 publications

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“…Nutritional (macro- and micronutrient) management is therefore very important for the management of PD [14, 15]. Published reports indicate that dietary treatment consists of locally available inexpensive foods and micronutrient supplementation had tremendous success rate in the management of PD among children [16, 17].…”

Section: Discussionmentioning

confidence: 99%

Treatment outcome of children with persistent Diarrhoea admitted to an Urban Hospital, Dhaka during 2012–2013

et al. 2017

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BackgroundDespite availability of treatment guidelines, persistent diarrhoea (PD) has been a major contributor of diarrhoeal deaths in low and middle income countries. We evaluated the outcome of children under the age of 5 years who were treated for PD using management algorithm with locally available foods in a diarrhoeal disease hospital in Dhaka.MethodsWe extracted retrospective data from electronic database for all the under-five children admitted for PD in the Longer Stay Ward and Intensive Care Unit of the Dhaka hospital at icddr,b between 2012 and 2013. Descriptive analysis was done to explore available baseline socio-demographic, nutritional, and co-morbid statuses, pathogens from stool isolates, duration of treatment, use of antibiotics, duration of hospital stay and treatment success rates. We sought to investigate above mentioned descriptive features in addition to associated factors with time to recover from PD using survival analysis with Cox proportional hazard model.ResultsA total number of 426 children with a median age of 7.46 (inter-quartile range IQR; 5.39, 9.43) months were admitted for PD during the study period. Of these, 95% of children were recovered from PD and discharged from the hospital. The median duration of treatment response was 6 (IQR 4, 9) days. The case fatality rate was 1.17%. Multivariate analysis among the children of 6 months or less showed that the rate of recovery from PD was 57% lower in children with severe stunting compared to those without severe stunting (HR 0.43, 95% CI 0.22, 0.88, p < 0.05), 42% lower in children with severe wasting (HR 0.58, 95% CI 0.36, 0.95, p < 0.05), and 81% reduced in children who developed hospital acquired infection (HAI) compared to those without HAI (HR 0.19, 95% CI 0.06, 0.62, p < 0.05). Among the children who were more than 6 months old, age in months (HR 1.05, 95% CI 1.02, 1.09) and female gender (HR 1.41, 95% CI 1.09, 1.84) had better rates of recovery from PD (p < 0.05). Moreover, among children more than 6 months of age, HAI (HR 0.44, 95% CI 0.26, 0.75), and antibiotic use (HR 0.40, 95% CI 0.28, 0.56) were associated with impeded recovery rates from PD (p < 0.05).ConclusionThe treatment guideline for persistent diarrhoea patients followed at icddr,b Dhaka hospital was found to be successful and can be used in other treatment facilities of Bangladesh and other developing countries where any treatment algorithm for PD is unavailable. More emphasis is required to be given for the prevention of hospital acquired infection that may help to limit the use of antibiotic in order to enhance the recovery rate from PD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0896-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Treatment outcome of children with persistent Diarrhoea admitted to an Urban Hospital, Dhaka during 2012–2013

et al. 2017

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“…70 % der Infektionen beruhten auf direktem Kontakt [34] [40,41]. Unter den häufigsten Ätiologien von chronischen Durchfällen finden sich auch infektiöse Auslöser; dies wird dann als "persistierende" Diarrhoe bezeichnet [40,41]. Eine AGE, deren Verlauf länger als erwartet ist, wird häufig auch als "prolongierte" Diarrhoe bezeichnet (Dauer 7 bis 14 Tage) (▶ Tab.…”

Section: I15 Statementunclassified

S2k-Leitlinie „Akute infektiöse Gastroenteritis im Säuglings-, Kindes- und Jugendalter“ – AWMF Registernummer 068-003

et al. 2019

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Leitlinie der Gesellschaft für pädiatrische Gastroenterologie und Ernährung (GPGE) gemeinsam mit der Deutschen Gesellschaft für Kinder-und Jugendmedizin (DGKJ), dem Berufsverband der Kinder-und Jugendärzte (BVKJ), der Deutschen Gesellschaft für pädiatrische Infektiologie (DGPI), der österreichischen Gesellschaft für Kinder-und Jugendheilkunde (ÖGKJ), der Deutschen Gesellschaft für Gastroenterologie, Verdauungs-und Stoffwechselstörungen (DGVS), dem Arbeitskreis "Krankenhaus & Praxishygiene" der AWMF und der Deutschen Gesellschaft für Pflegewissenschaft e. V. (DGPW)

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“…Insiden diare persisten di beberapa negara berkembang berkisar antara 7 -15% setiap tahun dan menyebabkan kematian sebesar 36 -54% dari seluruh kematian akibat diare. 1,2 Di Indonesia, prevalensi diare persisten/kronik sebesar 0,1% dengan angka kejadian tertinggi pada anak -anak berusia 6 -11 bulan. 2,3 Diare kronik adalah buang air besar dengan frekuensi yang meningkat dengan konsistensi tinja lebih lembek atau cair dan berlangsung dalam waktu lebih dari 2 minggu.…”

Section: Pendahuluanunclassified

“…Sebagian ahli lain berpendapat bahwa diare kronis merupakan kategori luas kondisi diare dengan etiologi non infeksius yang berlangsung lebih dari 2 minggu, dan ada lagi yang disebut dengan diare persisten yaitu diare yang berlangsung lebih dari 2 minggu dengan penyebab infeksius. 1,4 Secara umum penatalaksanaan diare kronik ditujukan untuk mencegah dan mengobati dehidrasi, gangguan keseimbangan elektrolit, malabsorpsi akibat kerusakan mukosa usus, penyebab diare yang spesifik, gangguan gizi serta mengobati penyakit penyerta 5 . Dioctahedral smectite (diosmektit) adalah mineral tanah liat yang bersifat absorben yang dapat digunakan untuk pengobatan diare 6 .…”

Section: Pendahuluanunclassified

Dioctahedral Smectite Memperpendek Durasi Diare Kronik Pada Anak

Wibowo¹,

Primawardani²

2018

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Diare kronik merupakan salah satu masalah saluran cerna tersering pada anak yang dialami oleh sekitar 3-20 % anak dari seluruh episode diare pada balita adalah diare khronis. Diare kronik ditandai dengan diare yang berlangsung lebih dari 2 minggu. Dioctahedral smectite merupakan adsorben yang dipakai luas dalam pengobatan diare pada anak. Ia mampu mengabsorbsi toksin, bakteri dan rotavirus, serta mencegah perlekatannya pada membran usus. Dioctahedral smectite juga bermanfaat memperkuat barrier mukosa usus dan ketika tidak ada mukus mencegah kerusakan mukosa usus. Penelitian ini bertujuan untuk meneliti manfaat dioctahedral smectite dalam memperpendek masa diare pada anak dengan diare khronis. Seratus empat puluh lima dari anak dengan diare kronis yang dirawat di RS Dr. Saiful Anwar Malang pada bulan Januari 2012-Desember 2016 dievaluasi dalam penelitian ini. Pasien dengan darah dan parasit pada hasil feses lengkap dikeluarkan dari penelitian. Terdapat 45 pasien yang memenuhi kriteria inklusi. Pasien dibedakan menjadi 2 kelompok, yang mendapatkan dioctahedral smectite (14 pasien) dan yang tidak (31 pasien), kemudian dilakukan perbandingan lama diare antara dua kelompok. Rata-rata lama diare pada pasien yang mendapatkan dioctahedral smectite lebih pendek daripada yang tidak, dan lama diare ini berbeda secara bermakna (p < 0,05). Dioctahedral smectite dapat menurunkan durasi diare pada anak dengan diare kronik. Kata kunci : anak, diare kronik, dioctahedral smectite.

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How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

Cited by 18 publications

References 17 publications

Treatment outcome of children with persistent Diarrhoea admitted to an Urban Hospital, Dhaka during 2012–2013

Treatment outcome of children with persistent Diarrhoea admitted to an Urban Hospital, Dhaka during 2012–2013

S2k-Leitlinie „Akute infektiöse Gastroenteritis im Säuglings-, Kindes- und Jugendalter“ – AWMF Registernummer 068-003

Dioctahedral Smectite Memperpendek Durasi Diare Kronik Pada Anak

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