Factors determining recovery during nutritional therapy of persistent diarrhoea: the impact of diarrhoea severity and intercurrent infections

Acta Paediatr. 1997 Aug;86(8):796-802. doi: 10.1111/j.1651-2227.1997.tb08600.x.

Abstract

The recovery pattern and outcome were analysed in 261 consecutive children (age 6-36 months) with persistent diarrhoea who underwent inpatient nutritional rehabilitation with a rice-lentil (Khitchri) and yoghurt-based diet. Overall, 217 (83%) recovered successfully, as judged by a reduction in stool output and weight gain for a consecutive 3 d. Failures were more commonly febrile at admission [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.1-4.8] and a greater number had culture-proven sepsis (Fisher's exact test, p < 0.001). Logistic regression analysis identified significantly increased risk of treatment failure with several admission characteristics, including stool frequency > 5 d(-1) (OR 2.9, 95% CI 1.6-5.2), vomiting (OR 2.5, 95% CI 1.1-5.7) and sepsis (OR 2.8, 95% CI 1.1-7.5). Survival analysis revealed significantly longer time-to-recovery among children with stool frequency > 5 d(-1) at admission (p < 0.001), suspected sepsis necessitating intravenous antibiotics (p < 0.001) or oral candidiasis (p < 0.05). These findings suggest that severity of diarrhoea and coexisting systemic infections are key determinants of the response to nutritional therapy in children with persistent diarrhoea.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Chronic Disease
  • Diarrhea / complications
  • Diarrhea / mortality
  • Diarrhea / therapy*
  • Diarrhea, Infantile / complications
  • Diarrhea, Infantile / mortality
  • Diarrhea, Infantile / therapy*
  • Energy Intake
  • Enteral Nutrition* / methods
  • Fabaceae
  • Humans
  • Infant
  • Logistic Models
  • Oryza
  • Plants, Medicinal
  • Survival Analysis
  • Treatment Outcome
  • Yogurt