Fauveau V, Henry F J, Briend A, Yunus M, Chakraborty J
International Centre for Diarrhoeal Disease Research, Bangladesh.
Acta Paediatr Suppl. 1992 Sep;381:12-4. doi: 10.1111/j.1651-2227.1992.tb12365.x.
To determine the importance of persistent diarrhea in childhood mortality a multiple-step verbal autopsy method was used to study 1934 deaths in Matlab, Bangladesh. We found that most of the deaths from acute watery diarrhea occurred in infancy, whereas the peak of non-watery diarrhea deaths was in children over 12 months of age. Children suffering from persistent diarrhea and malnutrition were at highest risk of dying during their third year of life. Children with infectious diseases have a two to four times higher risk of dying if they are malnourished, and for diarrhea the risk is 17 times as high. Forty-nine percent of the diarrheal deaths were in children with malnutrition associated with persistent diarrhea. These results imply that fluid and dietary management are key aspects in the treatment of diarrhea, particularly for those episodes which persist. We conclude that attempts to reduce diarrhoeal deaths with vertical ORT programmes will not have major impact unless other interventions are directed to the persistent diarrhoea-malnutrition complex.
为确定持续性腹泻在儿童死亡率中的重要性，我们采用多步骤的口头尸检方法，对孟加拉国马特拉布的1934例死亡病例进行了研究。我们发现，急性水样腹泻导致的死亡大多发生在婴儿期，而非水样腹泻死亡的高峰则出现在12个月以上的儿童中。患有持续性腹泻和营养不良的儿童在其生命的第三年死亡风险最高。患有传染病的儿童若营养不良，死亡风险会高出两到四倍，而腹泻的风险则高出17倍。49%的腹泻死亡病例是患有与持续性腹泻相关营养不良的儿童。这些结果表明，液体和饮食管理是腹泻治疗的关键方面，特别是对于持续性腹泻病例。我们得出结论，除非针对持续性腹泻-营养不良综合征采取其他干预措施，否则通过垂直口服补液疗法项目来减少腹泻死亡的努力不会产生重大影响。
