Risk Factors For Persistent Diarrhea In Children Under Five Year Of Age In A Tertiary Care Institute Of Haryana

Abstract

Introduction: Diarrheal diseases rank as the second most common cause of mortality in children below the age of five. According to the World Health Organization, persistent diarrhea is defined as diarrhea that persists for a duration of more than fourteen days. Persistent diarrhea makes up only 10 % of all cases of diarrhea but up to 35 % of mortality in children under five years of age. Sixty percent of PD cases appear in the first six months of life, and 90 percent in the first year Case fatality rate for persistent diarrhea is higher (14%) as compared to the acute diarrhea (0.7%)

Aim: To assess risk factors associated with persistent diarrhea in children under five years of age.

Material and Methods: This prospective case control study was carried out in the department of Paediatrics at a tertiary care institute of Haryana from April 2022 to April 2023. A total of 70 cases of persistent diarrhea among children < 5 years of age fulfilling the inclusion criteria and exclusion criterion and equal number of controls with acute diarrhea were enrolled in the study after taking written informed consent from one of the parent. Detailed history and clinical examination was carried. All the study subjects were given treatment as per standard guidelines.

Results:. Infants of age between 1 months and 1 year constituted about 55.71% of total cases of persistent diarrhea, 1-3 years constituting 37.14% cases of persistent diarrhea and 3-5 years of age accounts for rest of 7.15 % of cases. Study subjects showed male predominance with 55.7% male and 44.3% female children. Protein energy malnutrition, parenteral infection, exclusive breast feeding and use of unsafe drinking water all were found to be independent risk factors associated with persistent diarrhea. In total five death were reported in cases of persistent diarrhea and rest 65 patients were discharged and in controls all seventy patients were discharged without any mortality. The overall mortality rate of cases of persistent diarrhea was 7.14%.

Conclusion: Persistent diarrhea is substantial health problem in children under 1 year of age (55.71%). Lack of breast feeding, irrational use of antibiotics, parenteral infections, protein energy malnutrition and use of unsafe drinking water were the independent risk factors for persistent diarrhea occurrence.