Rahmat Dedy, Firmansyah Agus, Timan Ina S, Bardosono Saptawati, Prihartono Joedo, Gayatri Pramita
Department of Child Health, Fatmawati General Hospital, Jakarta, Indonesia.
Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Clin Exp Pediatr. 2023 Dec;66(12):538-544. doi: 10.3345/cep.2023.00668. Epub 2023 Nov 16.
Prolonged diarrhea, defined as diarrhea lasting longer than 7 days, is known to negatively impact children's growth and development. However, studies of the risk factors of prolonged diarrhea remain limited.
This study aimed to analyze the risk factors for prolonged diarrhea in children under 2 years of age with acute diarrhea.
This 1-year nested case-control study was conducted at Fatmawati General Hospital in 2021-2022. Participants were selected using a consecutive sampling method from among children under 2 years of age with acute diarrhea within the previous 2-4 days. Children with diarrhea that lasted 7 days were considered positive for prolonged diarrhea, whereas those with acute diarrhea were considered negative. Children with comorbidities such as malnutrition were excluded. Clinical information including age, breastfeeding history, antibiotic exposure history, and nutritional status was recorded. Complete blood count, blood zinc levels, Rotavirus, adenovirus, and norovirus serology, alpha-1 antitrypsin (AAT) levels, and stool analysis were acquired as laboratory data.
There were 62 subjects in the study and control groups. Overall, the median age was 12 months (6-24 months); most patients were boys. A history of antibiotic use (odds ratio [OR], 15.860; 95% confidence interval [CI], 5.286-47.591; P<0.001), zinc deficiency (OR, 4.758; 95% CI, 1.711-13.229; P=0.003), and elevated fecal AAT levels (OR, 2.677; 95% CI, 1.046-6.850; P=0.040) were the main risk factors for prolonged diarrhea in children under 2 years of age with acute diarrhea.
A history of antibiotic use, zinc deficiency, and elevated fecal AAT levels were the main risk factors for prolonged diarrhea in children under 2 years of age with acute diarrhea. Thorough testing and appropriate antibiotic use are required to prevent prolonged diarrhea in children under 2 years of age.
长期腹泻定义为腹泻持续超过7天，已知会对儿童的生长发育产生负面影响。然而，关于长期腹泻危险因素的研究仍然有限。
本研究旨在分析2岁以下急性腹泻儿童长期腹泻的危险因素。
这项为期1年的巢式病例对照研究于2021年至2022年在法玛瓦蒂综合医院进行。采用连续抽样方法从过去2 - 4天内2岁以下急性腹泻儿童中选取参与者。腹泻持续7天的儿童被视为长期腹泻阳性，而急性腹泻儿童被视为阴性。排除患有营养不良等合并症的儿童。记录包括年龄、母乳喂养史、抗生素接触史和营养状况等临床信息。获取全血细胞计数、血锌水平、轮状病毒、腺病毒和诺如病毒血清学、α-1抗胰蛋白酶（AAT）水平以及粪便分析作为实验室数据。
研究组和对照组共有62名受试者。总体而言，中位年龄为12个月（6 - 24个月）；大多数患者为男孩。使用抗生素史（比值比[OR]，15.860；95%置信区间[CI]，5.286 - 47.591；P<0.001）、锌缺乏（OR，4.758；95% CI，1.711 - 13.229；P = 0.003）以及粪便AAT水平升高（OR，2.677；95% CI，1.046 - 6.850；P = 0.040）是2岁以下急性腹泻儿童长期腹泻的主要危险因素。
使用抗生素史、锌缺乏以及粪便AAT水平升高是2岁以下急性腹泻儿童长期腹泻的主要危险因素。需要进行全面检测并合理使用抗生素以预防2岁以下儿童出现长期腹泻。
