Demographic profile of diarrhoea in malnourished children
DOI:
https://doi.org/10.18203/2349-3291.ijcp20243476Keywords:
Diarrhoea, Malnutrition, Dehydration, DysenteryAbstract
Background: Diarrhoeal illnesses impair both weight and height gains, with the most pronounced impacts observed in cases of recurrent episodes. Malnutrition can exacerbate diminished human performance, hinder physical growth, and retard cognitive development, and it is concomitant with increased frequency, duration, and severity of diarrhoeal events. The interrelationship between diarrhoea and malnutrition is intricately linked to factors related to water, sanitation, and hygiene, albeit through distinct pathophysiological mechanisms. Recurrent diarrhoeal episodes, infections, and inadequate hygiene practices can exacerbate these outcomes. Essentially, each diarrhoeal episode exacerbates nutritional deficits and fluid loss, thereby intensifying the severity of both malnutrition and dehydration. Aims and objectives were to identify and describe the demographic profile of malnourished children who experience diarrhoea, including age, sex, birth order and immunization status and to evaluate the impact of demographic variables on the severity of diarrhoea in malnourished children.
Methods: The present observational study was carried out in Outpatient department as well as inpatient department in department of pediatrics at Acharya Shri Chander College of Medical Sciences and Hospitals after obtaining ethical permission from institution with reference no. ASCOMS/IEC/2024/Meeting-II/FM/15, over a period of six months, w.e.f. 01 January 2024 to 31 June 2024. A total of 260 malnourished children were included in the study after obtaining the informed consent from their parents/guardians.
Results: In our study out of 260 malnourished children of age group 6 months to 5 years, 125 had diarrhoeal disease in which 76 (60.8%) were male and 49 (39.2%) were females with male to female ratio was 1.55:1 and majority of the study subjects were in the age group of 1-2 years (60%), followed by 6-12 months (24%), followed by 2-5 years (16%) and out of 76 male malnourished children who had diarrhoea, 52.6% were found to have grade II Indian Academy of Pediatrics (IAP) classification of malnutrition followed by 21%, 18.4% and 8% have grade III, grade I and grade IV respectively whereas out of 49 malnourished female child who had diarrhoea, 34.7% were having grade I IAP classification of malnutrition whereas grade II and grade III were found almost similar numbers 26.5% and 24.5% respectively and 14.3% had grade IV IAP classification of malnutrition.
Conclusions: The present study concluded that the malnutrition engenders diarrhoeal manifestations through a variety of mechanisms, while diarrhoea, in turn, exacerbates the degradation of nutritional status. Moreover, 13.6% of cases of diarrhoea becomes chronic has significant implication and highlights the need of early intervention and effective management strategies to prevent acute cases from developing into chronic.
References
World Health Organization. Network on Household Water Treatment and Safe Storage. 2005. Available at: https://www.who.int/teams/environment-climate-change-and-health/water-sanitation-and-health/ water-safety-and-quality/household-water-treatment -and-safe-storage. Accessed on 08 September 2024.
World Health Organization. Water, sanitation and hygiene: Public Health and the Environment. 2007. Available at: https://www.who.int/health-topics/ water-sanitation-and-hygiene-wash. Accessed on 08 September 2024.
World Health Organization. Diarrhoeal disease. 2018. Available at: https://www. who.int/ news-room/fact-sheets/detail/diarrhoeal- disease. Accessed on 08 September 2024.
Kazandjian S, Dupierrix E, Gaash E, Love IY, Zivotofsky AZ, De Agostini M, et al. Egocentric reference in bi-directional readers as measured by the straight-ahead pointing task. Brain Res. 2009;1247:133-41.
Mazumder RN, Ashraf H, Hoque SS, Kabir I, Majid N, Wahed MA, et al. Effect of an energy- dense diet on the clinical course of acute shigellosis in under- nourished children. Br J Nutr. 2000;84:775-9.
According to National Health Family survey-5 (2019-21) of India. Available at: https://main.mohfw. gov.in/sites/default/files/NFHS-5_Phase-II_0. Accessed on 08 September 2024.
Anand K, Sundaram KR, Lobo J, Kapoor SK. Are diarrheal incidence and malnutrition related in under five children? A longitudinal study in an area of poor sanitary conditions. Indian Pediatr. 1994;31(8):943-8.
Ngure FM, Reid BM, Humphrey JH, Mbuya MN, Pelto G, Stoltzfus RJ. Water, sanitation, and hygiene (WASH), environ- mental enteropathy, nutrition, and early child development: making the links. Ann N Y Acad Sci. 2014;1308:118-28.
Masibo PK, Makoka D. Trends and determinants of under- nutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993. 1998, 2003 and 2008. Public Health Nutr. 2012;15:1715-27.
Jarman AF, Long SE, Robertson SE, Nasrin S, Alam NH, McGregor AJ, et al. Sex and Gender Differences in Acute Pediatric Diarrhea: A Secondary Analysis of the DHAKA Study. J Epidemiol Glob Health. 2018;8(1-2):42-7.
Avachat SS, Phalke VD, Phalke DB, Aarif SM, Kalakoti P. A cross-sectional study of socio-demographic determinants of recurrent diarrhoea among children under five of rural area of Western Maharashtra, India. Australas Med J. 2011;4(2):72.
Negi K. Demographic profile of children affected with diarrhoea in a rural community of Varanasi 34th Annual Conference of IPHA. 1995.
Lal P, Joshi PL, Bhattacharya M. The magnitude of diarrhoea in children in urban slums of Allahabad. Indian J PSM. 1993;24(4):148-52.
Ahmed SF, Farheen A, Muzaffar A, Mattoo GM. Prevalence of diarrhoeal disease, its seasonal and age variation in under-fives in Kashmir, India. Int J Health Sci. 2008;2(2):126.
Verduci E, Banderali G, Barberi S, Radaelli G, Lops A, Betti F, et al. Epigenetic effects of human breast milk. Nutrients. 2014;6(4):1711-24.
Meshram II, Laxmaiah A, Venkaiah K, Brahmam GNV. Impact of feeding and breastfeeding practices on the nutritional status of infants in a district of Andhra Pradesh, India. Natl Med J India. 2012;25(4):201-6.
Arifeen S, Black RE, Antelman G, Baqui A, Caulfield L, Becker S. Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics. 2001;108(4):E67.
Islam MA, Ahmed T, Faruque AS, Rahman S, Das SK, Ahmed D, et al. Microbiological quality of complementary foods and its association with diarrhoeal morbidity and nutritional status of Bangladeshi children. Eur J Clin Nutr. 2012;66(11):1242-6.
