Risk factors of persistent diarrhoea in children below five years of age

Persistent diarrhoea has been identified as a major source of morbidity in the developing world. This study was conducted to evaluate the risk factors of persistent diarrhoea in children below five years of age. The data used is from a prospective analytical case control study carried out in the Department of Paediatrics, Dow Medical College and Civil Hospital, Karachi, during 1993-94. A total of 50 cases of persistent diarrhoea and 50 acute diarrhoeal controls (matched for age and sex) under 5 comprised the study subjects in this analysis. The maximum incidence of persistent diarrhoeal episodes occurred in children below one year of age. Male to female ratio was 3:2. The seasonal variation showed a peak incidence in summer rainy season. Risk factors for persistent diarrhoea recorded were young age, poor nutritional status, irrational use of antibiotics during acute diarrhoea, lack of exclusive breast feeding, incomplete vaccination, lack of tap water supply and sanitation facility at home and income < Rupees 2000/month of the earning members of the family. Thus, it is concluded that discouraging the irrational use of antibiotics and other drugs for the treatment of diarrhoea, promotion of breast feeding and Expanded Programme of Immunization (EPI), Standard Diarrhoea Case Management courses for doctors, medical students and paramedical staff and provision of safe drinking water and sanitation facility are important for the prevention of persistent diarrhoea.