Risk factors for persistent diarrhea among children under 2 years of age. Case control study.

A case control study was done at the Institute of Child Health, Madras, among prospectively recruited children aged 1-23 months to identify the risk factors for persistent diarrhea. Cases were children with diarrhea persisting for > 14 days. Controls were children with acute diarrhea who had recovered within 7 days. Two controls for each case, matched for age were recruited. The total number of cases and controls recruited were 170 and 340. Fifteen risk factors for association with persistent diarrhea were studied. When the factors were adjusted for covariables by logistic regression, only 6 factors were found to be significant, namely, malnutrition (OR 2.9; 95% CI 1.9-4.5), dysenteric stools (OR 2.4; 95% CI 1.3-4.3), indiscriminate use of antimicrobials (OR 2.4; 95% CI 1.6-3.9), associated illnesses (OR 2.1; 95% CI 1.5-3.1), stools > 10/day (OR 1.8; 95% CI 1.2-2.8) and persistence of dehydration (OR 1.4; 95% CI 1.2-1.7). However, when invasive diarrhea was excluded, weight loss during study period became a significant factor. It is concluded that all children with acute diarrhea should be investigated for associated illnesses and treated adequately, indiscriminate use of antimicrobials should be avoided and nutritional support should be provided.