Ekanem E E, Adedeji O T, Akitoye C O
Department of Community Health, College of Medicine, University of Lagos, Nigeria.
J Diarrhoeal Dis Res. 1994 Mar;12(1):19-24.
Prolonged diarrhoea is a particular health concern because it contributes significantly to diarrhoea-related deaths. Studies of risk factors for prolonged or persistent diarrhoea are virtually nonexistent in Africa. In the present study conducted in a semi-urban area of Lagos, we used a case-control design to evaluate the roles of household environment, mothers' food hygiene behaviour, and child-care practices as possible risk factors for prolonged diarrhoea in children 6-36 months old. A total of 628 children were studied. During the 3 1/2 months surveillance period, 166 children became ill with diarrhoea and 20 of the 166 (12.0%) had prolonged episodes (> 7 days). Persistent diarrhoea (> 14 days) accounted for only 2.4% (6 of 251) of all episodes. This analysis of risk factors is focussed on the 20 cases of prolonged diarrhoea and 206 randomly selected controls who experienced no diarrhoea during the surveillance period. A significantly high risk of prolonged diarrhoea was found among children who were given ogi, a maize pap, as the main diet (odds ratio = 4.13). Children who were fed mainly with foods bought from street vendors also had a significantly higher risk (odds ratio = 2.91) of prolonged diarrhoea. No association was found between domestic, environmental, and personal hygiene practices and prolonged diarrhoea. Foods from street vendors may serve as one source of diarrhoeal illnesses in Lagos and such episodes could be prolonged following repeated exposure, especially in children who are fed mainly with a low-energy and low-nutrient-density diet such as ogi.
长期腹泻是一个特别值得关注的健康问题，因为它在与腹泻相关的死亡中占很大比例。在非洲，几乎不存在关于长期或持续性腹泻危险因素的研究。在拉各斯一个半城市地区进行的本研究中，我们采用病例对照设计，以评估家庭环境、母亲的食品卫生行为以及儿童护理习惯作为6至36个月大儿童长期腹泻可能危险因素的作用。总共研究了628名儿童。在3个半月的监测期内，166名儿童患腹泻病，其中20名（12.0%）腹泻持续时间较长（>7天）。持续性腹泻（>14天）仅占所有腹泻病例的2.4%（251例中的6例）。本危险因素分析聚焦于20例长期腹泻病例以及206名在监测期内未患腹泻的随机选择的对照。以玉米糊ogi作为主要饮食的儿童患长期腹泻的风险显著较高（比值比=4.13）。主要食用从街头小贩处购买食物的儿童患长期腹泻的风险也显著较高（比值比=2.91）。未发现家庭、环境和个人卫生习惯与长期腹泻之间存在关联。在拉各斯，街头小贩出售的食物可能是腹泻病的一个来源，反复接触后腹泻可能会持续，尤其是对于那些主要食用低能量和低营养密度饮食（如ogi）的儿童。
