Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, RI, USA.
J Epidemiol Glob Health. 2018 Dec;8(1-2):42-47. doi: 10.2991/j.jegh.2018.08.102.
Pediatric diarrheal disease is a significant source of morbidity and mortality in the developing world. While several studies have demonstrated an increased incidence of diarrheal illness in boys compared with girls in low- and middle-income countries (LMIC), the reasons for this difference are unclear. This secondary analysis of the dehydration: assessing kids accurately (DHAKA) derivation and validation studies included children aged <5 years old with acute diarrhea in Dhaka, Bangladesh. The dehydration status was established by percentage weight change with rehydration. Multivariable regression was used to compare percent dehydration, while controlling for differences in age and nutritional status. In this cohort, a total of 1396 children were analyzed; 785 were male (56.2%) and 611 were female (43.8%). Girls presenting with diarrhea were older than boys (median age 17 months vs. 15 months, = 0.02) and had significantly more malnutrition than boys, even when controlled for age (mean 134.2 mm vs. 136.4 mm, < 0.01). The mean percent dehydration did not differ between boys and girls after controlling for age and nutrition status ( = 0.25). Although girls did have higher rates of malnutrition than boys, measures of diarrhea severity were similar between the two groups, arguing against a cultural bias in care-seeking behavior that favors boys.
儿科腹泻病是发展中国家发病率和死亡率的重要原因。尽管有几项研究表明，在低收入和中等收入国家（LMIC）中，男孩患腹泻病的发病率高于女孩，但造成这种差异的原因尚不清楚。这项脱水：准确评估儿童（DHAKA）的衍生和验证研究的二次分析包括孟加拉国达卡 5 岁以下患有急性腹泻的儿童。通过补液后的体重变化百分比来确定脱水状态。使用多变量回归来比较脱水百分比，同时控制年龄和营养状况的差异。在该队列中，共分析了 1396 名儿童；785 名男性（56.2%），611 名女性（43.8%）。患有腹泻的女孩比男孩年龄大（中位数年龄 17 个月 vs. 15 个月， = 0.02），而且即使在控制年龄的情况下，营养不良的发生率也明显高于男孩（平均 134.2 毫米 vs. 136.4 毫米， < 0.01）。在控制年龄和营养状况后，男孩和女孩之间的脱水百分比没有差异（ = 0.25）。尽管女孩的营养不良发生率确实高于男孩，但两组之间腹泻严重程度的指标相似，这表明在寻求医疗护理方面没有偏向男孩的文化偏见。
