Dutta P, Mitra U, Rasaily R, Bhattacharya S K, Bhattacharya M K, Manna B, Gupta A, Kundu B
Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Beliaghata, Calcutta.
Indian Pediatr. 1995 Mar;32(3):313-21.
Records of all the diarrheal patients up to the age of 5 years who were admitted to and died in Dr. B.C. Roy Memorial Hospital for Children, Calcutta, between January and December 1990 were analyzed. The records were reviewed to assess the relative importance of three clinical types of diarrhea (acute watery diarrhea, acute dysentery and persistent diarrhea) as the causes of mortality. Annual hospital death rates of children suffering from acute watery diarrhea, dysentery and persistent diarrhea were 13.6%, 18.2% and 25.9%, respectively. Overall death rates in dysentery (p = 0.03) and persistent diarrhea groups (p < .00001) were significantly higher than watery diarrhea group. Maximum deaths occurred among children aged between 7 and 36 months in all categories of diarrhea. Shigella infected children had higher case fatality rate. In acute watery diarrhea, 30.9% cases were assigned to associated causes of death whereas the same could be assigned to 92.6% and 93.2% cases in dysentery and persistent diarrhea group, respectively. Deaths occurred in most of the cases who had bronchopneumonia as underlying cause, septicemia as immediate cause and protein calorie malnutrition as associated cause and these were most frequently associated in patients suffering from dysentery and persistent diarrhea. Only 2.0% children suffering from acute watery diarrhea had dehydration at the time of death. Significantly, a high percentage of deaths occurred among malnourished children who suffered from dysentery (54.4%) and persistent diarrhea. These data suggest that Diarrheal Disease Control Programme should also give emphasis on management of non watery, non-dehydrating type of diarrhea with complications.
对1990年1月至12月期间入住加尔各答BC罗伊儿童医院并死亡的所有5岁以下腹泻患者的记录进行了分析。审查这些记录以评估三种临床类型腹泻（急性水样腹泻、急性痢疾和持续性腹泻）作为死亡原因的相对重要性。患有急性水样腹泻、痢疾和持续性腹泻的儿童的年医院死亡率分别为13.6%、18.2%和25.9%。痢疾组（p = 0.03）和持续性腹泻组（p < 0.00001）的总体死亡率显著高于水样腹泻组。所有腹泻类型中，7至36个月大的儿童死亡人数最多。感染志贺氏菌的儿童病死率较高。在急性水样腹泻中，30.9%的病例被归因于相关死亡原因，而在痢疾和持续性腹泻组中，这一比例分别为92.6%和93.2%。大多数死亡病例的潜在病因是支气管肺炎，直接病因是败血症，相关病因是蛋白质热量营养不良，这些情况在患有痢疾和持续性腹泻的患者中最为常见。只有2.0%患有急性水样腹泻的儿童在死亡时出现脱水。值得注意的是，患有痢疾（54.4%）和持续性腹泻的营养不良儿童死亡比例很高。这些数据表明，腹泻病控制计划也应强调对伴有并发症的非水样、非脱水型腹泻的管理。
