Volume : 10, Issue : 02, February – 2023

Title:

05.RISK FACTORS REGARDING CHRONIC DIARRHEA AND WEIGHT LOSS IN CHILDREN OF DISTRICT RAJANPUR PUNJAB, PAKISTAN

Authors :

Shumaila Naz, Kousar Naureen, Tahira Shaheen

Abstract :

Objective: To assess the risk factors associated with chronic diarrhea and weight loss in the children of District Rajanpur Punjab, Pakistan. Methods: A purposive randomized controlled trial was conducted among the 100 children of District Rajanpur Punjab, Pakistan with ages between 6 and 36 months and mean age 26 months having more than 3 episodes of acute watery diarrhea for more than 36 hours. Results: 36% of the children were below 1 year of age, 34% belonged to 12-24 months and 30% were between 24-36 months. Only 32% were undergoing breastfeeding or exclusively breastfed. 62% had an updated vaccinated status. 64% were low for birth weight. 82% families were consuming the municipal water supplies drinking and cooking. 78% were living in a joint family system. 32% of the mothers were literate with a minimum of primary education and above. 70% of the children had an early weaning history below 6 months of age. Conclusion: It was observed that children who had a history of low birth weight below 2.5 kg, under 12 months of age, not or under breastfed during their infancy, nursed on formula milk, unvaccinated status, those consuming un boiled water (municipal water) and those who had a history of early weaning below 6 months of age suffered more episodes of watery diarrhea.

Cite This Article:

Please cite this article in press Shumaila Naz et al, Risk Factors Regarding Chronic Diarrhea And Weight Loss In Children Of District Rajanpur Punjab, Pakistan., Indo Am. J. P. Sci, 2023; 10 (02).

Number of Downloads : 10

References:

1. Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, et al. (2010) Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375: 1969–1987.
2. Victora CG, Bryce J, Fontaine O, Monasch R (2000) Reducing deaths from diarrhoea through oral rehydration therapy. Bull World Health Organ 78: 1246–1255.
3. Black RE (1993) Persistent diarrhea in children of developing countries. PediatrInfect-Dis-J 12: 751–761; discussion 762–754.
4. Moore SR, Lima NL, Soares AM, Oria RB, Pinkerton RC, et al. (2010) Prolonged episodes of acute diarrhea reduce growth and increase risk of persistent diarrhea in children. Gastroenterology 139: 1156–1164.
5. Bhutta ZA, Nelson EA, Lee WS, Tarr PI, Zablah R, et al. (2008) Recent advances and evidence gaps in persistent diarrhea. J Pediatr Gastroenterol Nutr 47: 260–265.
6. Bhandari N, Bhan MK, Sazawal S (1992) Mortality associated with acute watery diarrhea, dysentery and persistent diarrhea in rural north India. Acta-PaediatrSuppl 381: 3–6.
7. Black RE (1993) Epidemiology of diarrhoeal disease: implications for control by vaccines. Vaccine 11: 100–106.
8. Lazzerini M, Ronfani L (2008) Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. CD005436 p.
9. Black RE, Lopez de Romana G, Brown KH, Bravo N, Bazalar OG, et al. (1989) Incidence and etiology of infantile diarrhea and major routes of transmission in Huascar, Peru. Am J Epidemiol 129: 785–799 Issn. pp 0002–9262.
10. WHO (2004) World Health Organization (WHO) and United Nations Children’s Fund (UNICEF). Joint statement on the Clinical Management of Acute Diarrhea Geneva and New York: WHO and UNICEF.
11. Strand TA, Chandyo RK, Bahl R, Sharma PR, Adhikari RK, et al. (2002) Effectiveness and efficacy of zinc for the treatment of acute diarrhea in young children. Pediatrics 109: 898–903.
12. World Health Organization (1997) Integrated management of childhood illness. Geneva: World Health Organization.
13. Wood SN (2000) Modelling and Smoothing Parameter Estimation with Multiple Quadratic Penalties. JRStatistSocB 62: 413–428.
14. Diggle PJ, Liang KY, Zeger SL (1994) Analysis of Longitudinal Data. Oxford: Oxford Science Publications.
15. Hosmer DW, Lemeshow S (2000) Applied Logistic Regression. New York: John Wiley & Sons Inc.
16. Collett D (1994) Modelling Survival Data in Medical Research. London: Chapman & Hall.
17. Lemeshow S, Hosmer DW Jr. (1982) A review of goodness of fit statistics for use in the development of logistic regression models. Am J Epidemiol 115: 92–106.
18. Molbak K, Gottschau A, Aaby P, Hojlyng N, Ingholt L, et al. (1994) Prolonged breast feeding, diarrhoeal disease, and survival of children in Guinea-Bissau. BMJ 308: 1403–1406.
19. Molbak K, Jakobsen M, Sodemann M, Aaby P (1997) Is malnutrition associated with prolonged breastfeeding? [letter]. Int J Epidemiol 26: 458–459.
20. Baqui AH, Black RE, Sack RB, Yunus MD, Siddique AK, et al. (1992) Epidemiological and clinical characteristics of acute and persistent diarrhoea in rural Bangladeshi children. Acta Paediatr Suppl 381: 15–21.
21. MacDonald TT, Spencer J (1990) Ontogeny of the mucosal immune response. Springer Semin Immunopathol 12: 129–137.
22. Bhutta ZA, Bird SM, Black RE, Brown KH, Gardner JM, et al. (2000)
Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomized controlled trials. Am J Clin Nutr 72: 1516–1522.
23. Sazawal S, Black RE, Bhan MK, Bhandari N, Sinha A, et al. (1995) Zinc supplementation in young children with acute diarrhea in India [see comments]. N-Engl-J-Med 333: 839–844.
24. Sazawal S, Black RE, Ramsan M, Chwaya HM, Dutta A, et al. (2007) Effect of zinc supplementation on mortality in children aged 1-48 months: a communitybased randomised placebo-controlled trial. Lancet 369: 927–934.
25. Tielsch JM, Khatry SK, Stoltzfus RJ, Katz J, LeClerq SC, et al. (2007) Effect of daily zinc supplementation on child mortality in southern Nepal: a communitybased, cluster randomised, placebo-controlled trial. Lancet 370: 1230–1239.
26. Brooks WA, Santosham M, Naheed A, Goswami D, Wahed MA, et al. (2005) Effect of weekly zinc supplements on incidence of pneumonia and diarrhoea in children younger than 2 years in an urban, low-income population in Bangladesh: randomised controlled trial. Lancet 366: 999–1004.
27. Fischer Walker CL, Bhutta ZA, Bhandari N, Teka T, Shahid F, et al. (2006) Zinc supplementation for the treatment of diarrhea in infants in Pakistan, India and Ethiopia. J Pediatr Gastroenterol Nutr 43: 357–363.
28. Lanata CF, Black RE (1991) Lot quality assurance sampling techniques in health surveys in developing countries: advantages and current constraints. World Health Stat Q 44: 133–139.
29. Rowland HA (1978) The pathogenesis of diarrhoea. Trans R Soc Trop Med Hyg 72: 289–302.
30. Cook Mills JM, Wirth JJ, Fraker PJ (1990) Possible roles for zinc in destruction of Trypanosoma cruzi by toxic oxygen metabolites produced by mononuclear pha0067ocytes. Adv Exp Med Biol 262: 111–121.
31. Molbak K, Hojlyng N, Gottschau A, Sa JC, Ingholt L, et al. (1993) Cryptosporidiosis in infancy and childhood mortality in Guinea Bissau, west Africa. BMJ 307: 417–420.
32. Perch M, Sodemann M, Jakobsen MS, Valentiner-Branth P, Steinsland H, et al. (2001) Seven years’ experience with Cryptosporidium parvum in Guinea-Bissau, West Africa. Ann Trop Paediatr 21: 313–318.
33. Bahl R, Bhandari N, Hambidge KM, Bhan MK (1998) Plasma zinc as a predictor of diarrheal and respiratory morbidity in children in an urban slum setting. Am J Clin Nutr 68: 414 S–417S.
34. Brown KH (1998) Effect of infections on plasma zinc concentration and implications for zinc status assessment in low-income countries. Am J Clin Nutr 68: 425 S–429S.
35. Strand TA, Adhikari RK, Chandyo RK, Sharma PR, Sommerfelt H (2004) Predictors of plasma zinc concentrations in children with acute diarrhea. Am J Clin Nutr 79: 451–456.
36. Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, et al. (2007) Child development: risk factors for adverse outcomes in developing countries.
Lancet 369: 145–157.