Clinical profile of children with diarrhoea admitted in pediatric intensive care unit of Bal Chikitsalay, M.B. Hospital, RNT Medical College, Udaipur, Rajasthan, India
DOI:
https://doi.org/10.18203/2349-3291.ijcp20163680Keywords:
Acidosis, Diarrhoea, Electrolytes, Malnutrition, PICUAbstract
Background:In India, diarrhoea is the third most important cause of under-five mortality after pneumonia and complications of prematurity. According to a study, 22% of rotavirus associated deaths worldwide were from India. Two most important consequences of diarrhoea in children are malnutrition and dehydration. Malnutrition and diarrhoea form a vicious cycle, as malnutrition increases risk and severity of diarrhoea. Impaired absorption, loss of nutrients, increased catabolism and improper feeding aggravate severity of malnutrition. Significant dehydration with abnormal electrolytes and acid base status occurs, which may be fatal. The study was done to know prevalence of malnutrition and diarrhoea along with various acid base disorders associated with it.
Methods: Children of age group 1 month to 60 months of age were enrolled in the study. Relevant investigations were carried out and recorded.
Results:A total of 164 children were enrolled, out of which 86 were males and 78 females. Maximum numbers of children were infants. Rotavirus alone was responsible for 42% of children with severe dehydration. Nutritional status of children with diarrhoea showed high prevalence of malnutrition in children with severe dehydration, as one third of children had mid upper arm circumference less than 11.5cm. Most common complication was uremia.
Conclusions:Rotavirus diarrhoea was a major cause of severe dehydration in children. Malnutrition was associated in majority of children.
References
Jagadishan B, Yachha SK. Disease of Gastrintestinal system and liver. Ghai Essential Pediatrics, 8th edition. Srivastava A, Paul VK, Bagga A. CBS Publishers and distributors. India;2013:291.
Haricharan K, Srinivasa BM, Kumari V. Clinical and bacteriological study of diarrhoea in children. J Evolution Med Dental Sci. 2013;2(23):4229-37.
Bhat P, Macaden R, Unnykrishnnan P, Rao HG. Rotavirus and bacterial enteropathogens in acute diarrhoea of young children in Bangalore. Ind J Med Res. 1985;82:105-9.
Sen D, Saha MR, Nair B, Das P, Niyogi S, Bhattacharya SK, et al. Etiological spectrum of acute diarrhoea in hospitalized patients in Calcutta. Ind J Med Res. 1985;82:286-91.
Singh PB, Sreenivasan MA, Pavri KM. Viruses in acute gastroenteritis in children in Pune, India. Epidem Infect. 1989;102:345-53.
Dutta SR, Khalfan SA, Baig BH, Philipose L, Fulay Fil R. Epidemiology of rotavirus diarrhoea in children under five years in Bahrain. Int J Epidemiol. 1990;19:722-7.
Phukan AC, Patgiri DK, Mahanta J. Rotavirus associated acute diarrhoea in hospitalized children in Dibrugarh, north-east India. Indian J Pathol Microbiol. 2003;46:274-8.
Nakagomi O, Takahashi Y, Enoki M, Suzuki T, Kilgore PE. Incidence and Burden of Rotavirus Gastroenteritis in Japan, as Estimated from a Prospective Sentinel Hospital Study. J Infect Dis. 2005;192(1):106-10.
Tate JE, Burton AH. Estimate of worldwide rotavirus associated mortality in children younger than 5 years before introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis. 2008;12(2):136-41.
Gunn RA, Kimball AM, Pollard RA, Feeley JC. Bottle feeding as risk factor for cholera in infants. Lancet. 1979;6:730-2.
Duffy LC, Byers TE, Talty MR. The effect of infant feeding on rotavirus induced gastroenteritis: a prospective study. Am J Public Health. 1986;76(3):259-63.
Daral TS, Singh HP, Sachdev HP, Mohan M, Mathur M, Bhargava SK. Acute dehydrating diarrhoea: clinical profile in neonates and young infants. Ind Ped. 1985;22(5):333-8.
Reid SR, Losek JD. Hypoglecemia complicating dehydration in children with acute gastroenteritis. J Em Med. 2005;29(2):141-5.