Shahid N S, Sack D A, Rahman M, Alam A N, Rahman N
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
BMJ. 1988 Oct 22;297(6655):1036-8. doi: 10.1136/bmj.297.6655.1036.
With a systematically sampled population of children aged under 5 attending this centre for diarrhoeal disease research during 1983-5 a retrospective analysis of persistent diarrhoea (defined as greater than 14 days' duration) was performed to identify the possible risk factors for this syndrome. Of the 4155 children included in the analysis, 410 (10%) gave a history of persistent diarrhoea. A comparison with children with acute diarrhoea matched for age showed that 11 factors were correlated with persistent diarrhoea, and strongly associated factors were stools with blood or mucus, or both, lower respiratory tract infection, malnutrition, vitamin A deficiency, and antibiotic use before presentation. The peak age was 2 years, and there was no sex difference. Deaths occurred more often in the group with persistent diarrhoea. Although Shigella spp, Campylobacter jejuni, and Giardia lamblia were frequently identified, their rates of isolation were not significantly higher among patients with persistent diarrhoea. No seasonal variation was observed in the rates of persistent diarrhoea. Although the introduction of family food to the diet was associated with higher rates, this factor was difficult to separate from the age dependent risks.
1983年至1985年期间,对在该中心就诊的5岁以下患腹泻病儿童进行系统抽样,对持续性腹泻(定义为病程超过14天)进行回顾性分析,以确定该综合征可能的危险因素。在纳入分析的4155名儿童中,410名(10%)有持续性腹泻病史。与年龄匹配的急性腹泻儿童相比,有11个因素与持续性腹泻相关,密切相关的因素有带血或带黏液或两者皆有的粪便、下呼吸道感染、营养不良、维生素A缺乏以及就诊前使用抗生素。发病高峰年龄为2岁,无性别差异。持续性腹泻组的死亡发生率更高。虽然经常检出志贺菌属、空肠弯曲菌和蓝氏贾第鞭毛虫,但它们在持续性腹泻患者中的分离率并未显著更高。持续性腹泻的发生率未观察到季节性变化。虽然引入家庭食物与较高的发病率相关,但该因素难以与年龄相关风险区分开来。