Incidence of diarrhea: poor parental recall ability

Abstract

Several methodological issues may have an impact on the incidence rates of childhood acute diarrhea reported by community-based studies. This study was performed to assess the impact of parental recall ability and definition of diarrhea on the estimate of incidence of acute diarrhea. Eighty-four children younger than 40 months were randomly selected and visited every other day for four weeks and the occurrence of diarrhea was registered. On the last day of the study, another visit was performed and the informants were inquired about the occurrence of diarrhea during the previous four weeks. Data gathered during the four weeks were compared to those obtained on the last visit. Additionally, the informants' definition of diarrhea was investigated and compared to the one adopted by this study. During the observation period, 33 children suffered diarrhea, but only 10 (30.3%) informants reported the occurrence of diarrhea. Although 42.4% of those informants reported that their children had been ill over that period, they did not report diarrhea. Further, 60.6% children who had diarrhea suffered at least one episode in the two weeks prior to the visitation. The same definition of diarrhea used in this study was adopted by 52.1% of the informants inquired. Parental recall is an unreliable method to estimate the incidence of diarrhea and studies with a short interval between the visits should be necessary to correctly evaluate this important health problem. Moreover, assessing the informants' own definition of diarrhea is a significant contribution to the interpretation of the results.

A Cluster Randomized Controlled Trial to Reduce Childhood Diarrhea Using Hollow Fiber Water Filter and/or Hygiene–Sanitation Educational Interventions

“…A fourth study limitation is that we used a 2-week recall on the presence of diarrhea and did not collection information on the number of episodes or the severity or duration of episodes. It has been established that recall periods beyond 2 days can underreport events 33–36. Because of this tendency, we measured diarrheal disease prevalence conservatively, and therefore, the effect sizes given in this study are likely underestimates.…”

The Effect of Different Recall Periods on Estimates of Acute Gastroenteritis in the United States, FoodNet Population Survey 2006–2007

“…Although it is not clear which study provides the most accurate estimate, prospective cohort studies consistently report a lower frequency of acute gastroenteritis than cross-sectional surveys (Roy et al, 2006). The case definition used also has been shown to have an important impact on disease estimates (Majowicz et al, 2008 Evidence also exists that length of the recall period may impact estimates of the incidence of acute gastroenteritis, with a higher incidence of diarrhea being reported among both adults and children in developing countries when asked about shorter, more recent time periods (Ramakrishnan et al, 1999;Melo et al, 2007;Feikin et al, 2010). To examine the impact of recall period on estimates of the incidence of acute gastroenteritis in the United States, we designed the 2006-2007 The Foodborne Diseases Active Surveillance Network (FoodNet) Population Survey to address two specific questions: Would a 7-day recall period result in a higher prevalence of acute gastroenteritis than a 1-month recall period?…”

Can We Know Better?

“…The line which ends highest represents the cumulative funds spent by the TSC, closely related to the reported coverage. Source: http://www.developmentbookshelf.com/doi/book/10.3362/9781780449449 -Saturday, May 12, 2018 11:58:23 AM -IP Address:34.214.212.150 recall data can be very unreliable (Alam et al, 1989;de Melo et al, 2007) 10 and coverage was assumed to be the same as usage, when it is widespread practice in rural India for some members of households with functioning toilets to defecate in the open some or all of the time .…”

“…10. The Brazilian study (de Melo et al, 2007) found with visits every other day that over a four-week period, 33 out of 84 children under 40 months had diarrhoea but parental recall at the end of the period reported only 10. Issues included the understanding of what constituted diarrhoea.…”