Persistent diarrhoea: socio-demographic and clinical profile of 264 children seen at a referral hospital in Addis Ababa

Abstract

Acute diarrhoea is a major public health problem in Ethiopian children under five years of age. Reports for other developing countries indicate that persistent diarrhoea is emerging as an important cause of mortality and morbidity in this age group. Little is, however, known about the extent of the condition in our setting. The socio-demographic and clinical characteristics of children with persistent diarrhoea seen at a teaching hospital in Addis Ababa over an 18-month period is presented. Of 5,762 children with all forms of diarrhoea seen during the study period 264 (5%) had persistent diarrhoea. Most of the children (83%) were below 18 months of age and the peak occurrence was between the ages of seven and 12 months. The majority (86%) of the patients had associated malnutrition and 83% of the infants under four months of age were either fully or partially weaned. Watery diarrhoea with no dehydration was the main clinical feature. Nearly 7% of the patients had dysentery. Average family income was low and parental literacy level seem to have had no effect. It is suggested that breastfeeding and appropriate weaning practices be strongly promoted. Further work is proposed in order to determine the magnitude of the problem and identify the risk factors associated with the disease, including the unfavourable child and family unit characteristics and care seeking behaviours.

PIP: The sociodemographic and clinical characteristics of the 264 children with persistent diarrhea presenting to the Ethio-Swedish Children's Hospital in Addis Ababa, Ethiopia, in an 18-month period (1992-93) were investigated. The children with persistent diarrhea had an episode lasting at least 14 days and represented 5% of all children with diarrhea seen during the study period. 71% had watery diarrhea. 83% of children with persistent diarrhea were under 18 months of age; occurrence peaked at ages 7-12 months. 83% of affected infants under 4 months of age were fully or partially weaned. 16% were dehydrated and 66% were malnourished. The majority of children were from low-income families; 28% reported no income and 32% had an annual income under US$300. 27% of mothers of children with persistent diarrhea were illiterate, 31% had an elementary school education, and 42% had a secondary education. More information is needed on characteristics of children with diarrhea and their families, health care-seeking behaviors, and the time and money costs associated with care seeking. Also required, to prevent infantile diarrhea associated with contaminated milk or water, is promotion of breast feeding and appropriate weaning practices.