Chronic and persistent diarrhea in infants and young children: Status statement
- John Matthai
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Diarrhea that lasts for more than two weeks is a common cause of mortality and morbidity in infants and children. There is a need to update the information available on this subject in Indian context.
This review has analyzed the available published data on the subject with particular focus on developing countries. It has also outlined the current diagnostic and management practices in India based on the experience of the participants from major hospitals in different parts of the country.
Problem areas in both persistent and chronic diarrhea have been identified and remedial measures relevant to India are presented.
Micronutrient supplementation, algorithm based diet regimens, and good supportive care are sufficient in most children above 6 months of age with persistent diarrhea. Paucity of diagnostic facilities limits evaluation of chronic diarrhea in most parts of the country and regional laboratories need to be set up urgently. Lack of awareness regarding cow’s milk protein allergy, celiac disease and immunodeficiency associated diarrhea is of particular concern.
- Memorandum from a WHO meeting. Persistent diarrhea in children in developing countries. Bull WHO. 1988;66:709–717.
- Bhan M K, Bhandari N, Sazawal S, Clemens J, Raj P, Levine MM, et al. Longitudinal study of diarrhoeal disease among young children in rural north India. Bull WHO. 1989;67:281–288.
- Schorling JB, Wanke CA, Schorlling SK, McAullife JF, de Souza MA, Guerrat RL. A prospective study of persistent diarrhea among children in an urban Brazilian slum: patterns of occurrence and etiologic agents. Am J Epidemiol. 1990;132:144–156.
- Fauveau V, Henry FJ, Briend A, Yunus M, Chakraborty J. Persistent diarrhea as a cause of childhood mortality in rural Bangladesh. Acta Paediatr Suppl. 1992;381:12–14. CrossRef
- Alam S, Admed SH, Lamba LMS. Clinical profile of persistent diarrhea in a DTTU. Indian Pediatr. 1997;34:631–635.
- Mittal SK. Chronic Diarrhea in tropics. Indian J Pediatr. 1999;66:S4–S15.
- Ahmed F, Ansaruzzaman M, Haque E, Rao MR, Clemens JD. Epidemiology of post shigellosis persistent diarrhea in young children. Pediatr Infect Dis J. 2001;20:525–530.
- Fauveau V, Henry FJ, Briend A, Yunus M, Chakraborty J. Persistent diarrhea as a cause of childhood mortality in rural Bangladesh. Acta Paediatr. 1992;381:S 12–14. CrossRef
- Sullivan PB. Studies of the small intestine in persistent diarrhea and malnutrition: the Gambian experience. J Pediatr Gastroenterol Nutr. 2002;34:S11–S13. CrossRef
- Sazawal S, Black RE, Bhan MK, Bhandari N, Sinha A, Jalla S. Zinc supplementation in young children with acute diarrhea in India. N Engl J Med. 1995;333:839–844. CrossRef
- Baqui AH, Black RE, Sack RB, Chowdhury HR, Yunus M, Siddique AK. Malnutrition, cell-mediated immune deficiency and diarrhea: a community-based longitudinal study in rural Bangladeshi children. Am J Epidemiol. 1993;137:355–365.
- Taniguchi K, Rikimaru T, Yartey JE, Akpedonu, P, Armar-Klemesu MA, Nkrumah FK, et al. Immunological background in children with persistent diarrhea in Ghana. Pediatr Int. 1999;4:162–167. CrossRef
- Adejuyigbe EA, Oyelami O, Onayemi O, Durosinmi MA. Paediatric HIV/AIDS in Ile-Ife, Nigeria. Cent Afr J Med. 2003;49:74–78.
- Amadi B, Kelly P, Mwiya M, Mulwazi E, Sianongo S, Changwe F, et al. Intestinal and systemic infection, HIV, and mortality in Zambian children with persistent diarrhea and malnutrition. J Pediatr Gastroenterol Nutr. 2001;32:550–554. CrossRef
- Bhutta ZA, Hendricks KH. Nutritional management of persistent diarrhea in childhood: a perspective from the developing world. J Pediatr Gastroenterol Nutr. 1996;22:17–37. CrossRef
- Bhan MK, Bhandari N, Bhatnagar S, Bahl R. Epidemiology and management of persistent diarrhoea in children of developing countries. Indian J Med Res. 1996;104:103–114.
- International Working Group on Persistent Diarrhoea. Evaluation of an algorithm for the treatment of persistent diarrhoea: a multicentre study. Bull World Health Organ. 1996;74:479–489.
- Bhandari N, Bahl R, Saxena M, Taneja S, Bhan MK. Prognostic factors for persistent diarrhea managed in a community setting. Indian J Pediatr. 2000;67: 739–745. CrossRef
- Sarker SA, Mahalanabis D, Alam NH, Sharmin S, Khan AM, Fuchs GJ. Reduced osmolarity oral rehydration solution for persistent diarrhea in infants: a randomized controlled clinical trial. J Pediatr. 2001;138:532–538. CrossRef
- Dutta P, Mitra U, Dutta S, Manna B, Chatterjee MK, De A, et al. Hypo-osmolar oral rehydration salts solution in dehydrating persistent diarrhoea in children: double-blind, randomized, controlled clinical trial. Acta Paediatr. 2000;89:411–416. CrossRef
- Bhutta ZA, Bird SM, Black RE, Brown KH, Gardner JM, Hidayat A, et al. Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomized controlled trials. Am J Clin Nutr. 2000;72:1516–1522.
- Bhatanagar S, Bhan MK, Singh KD, Srivastav R. Prognostic factors in hospitalized children with persistent diarrhea: Implications for diet therapy. J Pediatr Gastroenterol Nutr. 1996;23:151–158. CrossRef
- Sheth M, Obrah M. Diarrhea prevention through food safety education. Indian J Pediatr. 2004;71:879–882. CrossRef
- Ganesh R, Suresh N, Sathiasekharan M. Celiac disease, still an uncommon problem in Tamilians? Indian J Gastroenterol. 2009;28:189. CrossRef
- Yachha SK, Misra S, Malik A K, Nagi B, Mehta S. Spectrum of malabsorption in North Indian children. Indian J Gastroenterol. 1993;12:120–125.
- Yachha SK, Poddar U. Celiac disease in India. Indian J Gastroenterol. 2007;26:230–237.
- Poddar U, Yachha SK, Krishnani N, Srivastava A. Cow’s milk protein allergy (CMPA): an entity for recognition in children in developing countries. J Gastroenterol Hepatol. 2010;25:178–182. CrossRef
- Chronic and persistent diarrhea in infants and young children: Status statement
Volume 48, Issue 1 , pp 37-42
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Chronic diarrhea
- Persistent diarrhea
- John Matthai (1)
- Author Affiliations
- 1. Department of Pediatrics, PSG Institute of Medical Sciences, Peelamedu, Coimbatore, 641 004, Tamil Nadu, India