Abstract
The diarrheal diseases are a major cause of death in all poor societies. Typically, these populations have a youthful age structure, with nearly half under 15 years of age and one-sixth under age 5.1 Yet over half of all deaths occur in children under 5 years, the age group at highest risk for diarrhea and malnutrition.2,3 In Latin America, for example, diarrhea was found to be by far the major infectious cause of death in children below age 5, and malnutrition was noted to be a direct or underlying cause of most deaths.3 In-depth longitudinal surveillance in rural Bangladesh has shown diarrhea to be responsible for 28.6% of all deaths in children under 5. Diarrhea accounted for 13.7% of all infant deaths, while among children 1 to 4 years of age, diarrhea was responsible for 44%.2
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References
United Nations. World Population and Its Age-Sex Composition by Country, 1950–2000: Demographic Estimation and Projection as Assessed in 1978. Population Division, Department of International Economic and Social Affairs, United Nations, New York, January 1980.
Chen, L. C., Rahaman, M., and Sarder, A. M. Epidemiology and causes of death among children in a rural area of Bangladesh. Int. J. Epidemiol. 9:25–33, 1980.
Puffer, R. R., and Serrano, C. V. Patterns of Mortality in Childhood, Sci. Public. No. 262. Pan American Health Organization, Washington, D.C. 1973.
Mata, L. J. The Children of Santa María Cauqué: A Prospective Field Study of Health and Growth. M.I.T. Press, Cambridge, Massachusetts, and London, England, 1978.
Mata, L. J., Urrutia, J. J., and Gordon, J. E. Diarrhoeal disease in a cohort of Guatemalan village children observed from birth to age 2 years. Trop. Geogr. Med. 19:247–257, 1967.
Rohde, J. E. Preparing for the next round: Convalescent care after acute infection. Am. J. Clin. Nutr. 31:2258, 1978.
Rohde, J. E., and Northrup, R. E. Taking science where the diarrhea is in acute diarrhea in childhood. CIBA Foundation Symposium 42. Elsevier/Excerpta Medica, Amsterdam, 1976.
Fox, J. P., Hall, C.E., Cooney, M. K., Luce, R. E., and Kronmal, R. A. The Seattle virus watch. II. Objectives, study population and its observation, data processing and summary of illnesses. Am. J. Epidemiol. 96:270–285, 1972.
Scrimshaw, N. S., Taylor, C. E., and Gordon, J. E. Interactions of Nutrition and Infection, World Health Organization Monograph Series No. 57. WHO, Geneva, 1968.
Annual Report, 1979. International Centre for Diarrhoeal Disease Research, Bangladesh, Dacca, 1980.
Martorell, R., Habicht, J. P., Yarbrough, C., Lechtig, A., Klein, R. E., and Western, K. A. Acute morbidity and physical growth in rural Guatemalan children. Am. J. Dis. Child. 129:1296, 1975.
Mata, L. J., Urrutia, J. J., Albertazzi, C., Pellecer, O., and Arellano, E. Influence of recurrent infections on nutrition and growth of children in Guatemala. Am. J. Clin. Nutr. 25:1267–1275, 1972.
Rowland, M. G. M., Cole, T. J., and Whitehead, R. G. A quantitative study into the role of infection in determining nutritional status in Gambian village children. Br. J. Nutr. 37:441–450, 1977.
Black, R. E., Huq, I., Merson, M. H., Alim, A. R. M. A., and Yunus, M. Incidence and severity of rotavirus and Escherichia coli diarrhea in rural Bangladesh: Implications for vaccine development. Lancet 1:141–142, 1981.
Black, R. E., Merson, M. H., Rahman, A. S. M. M., Yunus, M., Alim, A. R. M. A., Huq, I., Yolken, R. H., and Curlin, G. T. A two year study of bacterial, viral, and parasitic agents associated with diarrhea in rural Bangladesh. J. Infect. Dis. 142:660–664, 1980.
Barua, D., and Burrows, W. (Eds.). Cholera. W.B. Saunders, Philadelphia, 1974.
Mosley, W. H. Biological contamination of the environment by man. Paper presented at the IUSSP Seminar on Biological and Social Aspects of Mortality and Length of Life, Fuiggi, Terme, Italy, May 13–16, 1980.
Tallett, S., MacKenzie, C., Middleton, P., Keraner, B., and Hamilton, R. Clinical, laboratory, and epidemilogic features of a viral gastroenteritis in infants and children. Pediatrics 60:217–222, 1977.
Field, M. Mechanisms of action of cholera and Escherichia coli enterotoxins. Am. J. Clin. Nutr. 32:189–196, 1979.
Guerrant, R. L., Moore, R. A., Kirschenfeld, P. M., and Sande, M. A. Role of toxigenic and invasive bacteria in acute diarrhea of childhood. N Engl. J. Med 293:567–573, 1975.
Field, M., Fromm, D., Al-Awqati, A., and Greenough, W. B. Effect of cholera enterotoxin on ion transport across isolated ileal mucosa. J. Clin. Invest. 51:796, 1972.
Dupont, H. L. Pathogenesis of enteric diarrhea and gut immune mechanisms in defense against enteric infection. In: Proceedings of the XIV International Congress of Pediatrics, Buenos Aires, Argentina, October 1974, p. 96.
Levine, M. M., DuPont, H. L., Formal, S., Hornick, R. B., Takeuchi, A., Gangarosa, E. J., Snyder, M. J., and Libonati, J. P. Pathogenesis of Shigella dysenteriae I (Shiga) dysentery. J. Infect. Dis. 127:261, 1973.
Hughes, J. M., Murad, F., Chang, B., and Guerrant, R. L. Role of cyclic GMP in the action of heat-stable enterotoxin of Escherichia coli. Nature 271:755, 1978.
Rodriquez, W. J., Kim, H. W., Arrobio, J. O., Brandt, C. D., Chanock, R. M., Zapikian, A. Z., Wyall, R. G., and Parrott, R. H. Clinical features of acute gastroenteritis associated with human reovirus-like agent in infants and young children. J. Pediatr. 91: 188–193, 1977.
Sack, D. A., Rhoads, M., Molla, A., Molla, A. M., and Wahed, M. A. The role of carbohydrate malabsorption in determining the severity of rotavirus diarrhea. International Centre for Diarrhoeal Disease Research, Bangladesh, 1981.
Keusch, G. T., Grady, G. F., Mata, L. J., and McIver, J. The pathogenesis of Shigella diarrhea. I. Enterotoxin production by Shigella dysenteriae 1. J. Clin. Invest. 51:1212, 1972.
Creed, H. M., and Graham, G. G. Determinants of growth among poor children. I. Food and nutrient intake. Am. J. Clin. Nutr. 33:715–722, 1980.
Hirschhorn, N., and Denny, K. M. Oral glucose-electrolyte therapy for diarrhea: A means to maintain or improve nutrition? Am. J. Clin. Nutri. 28:189, 1975.
Hoyle, B., Yunus, M., and Chen, L. C. Breast-feeding and food intake among children with acute diarrheal disease. Am. J. Clin. Nutr. 33:2365–2371, 1980.
Martorell, R., Yarbrough, C., Yarbrough, S., and Klein, R. E. The impact of ordinary illnesses on the dietary intakes of malnourished children. Am. J. Clin. Nutr. 33:345–350, 1980.
Mata, L. J., Kronmal, R. A., Urrutia, J. J., and Garcia, B. Effect of infection on food intake and nutritional state: Perspectives as viewed from the village. Am. J. Clin. Nutr. 30:1215, 1977.
Murray, M. J., and Murray, A. B. Anorexia of infection as a mechanism of host defense. Am. J. Clin. Nutr. 32:593–596, 1979.
Einstein, L. P., McKay, D. M., and Rosenberg, I. H. Pediatric xylose malabsorption in East Pakistan: Correlation with age, growth retardation, and weanling diarrhea. Am. J. Clin. Nutr. 25:1230, 1972.
Lindenbaum, J. Malabsorption during and after recovery from acute intestinal infection. Br. Med. J. 2:326, 1965.
Rosenberg, I. H., and Scrimshaw, N. S. (Eds.). Workshop on malabsorption and nutrition, Parts I and II. Am. J. Clin. Nutr. 25:1046; 1226, 1972.
Rosenberg, I. H., Solomons, N. W., and Schneider, R. E. Malabsorption associated with diarrhea and intestinal infections. Am. J. Clin. Nutr. 30:1248–1253, 1977.
Brown, K. H., Parry, L., Khatum, M., and Ahmed, M. G. Lactose malabsorption in Bangladeshi children: Relation with age, history of recent diarrhea, nutritional status, and breast-feeding. Am. J. Clin. Nutr. 32:1962–1969, 1979.
Hirschhorn, N., Molla, A., and Molla, A. M. Reversible jejunal disaccharidase deficiency in cholera and other acute diarrheal diseases. Johns Hopkins Med. J. 125:291–300, 1969.
Rosensweig, N. S. Diet and intestinal enzyme adaptation: Implications for gastrointestinal disorders. Am. J. Clin. Nutr. 28:648–655, 1975.
Chung, A. The effect of oral feeding at different levels on the absorption of foodstuffs in infantile diarrhea. J. Pediatr. 33:1–13, 1948.
Chung, A., and Viščorová, B. The effect of early oral feeding versus early oral starvation on the course of infantile diarrhea. J. Pediatr. 33:14–22, 1948.
Beisel, W. R. Metabolic response to infection. Ann. Rev. Med. 26:9, 1975.
Beisel, W. R. Nutrient wastage during infection. In: Proceedings of the Ninth International Congress of Nutrition 2:160, 1970.
Beisel, W. R., Sawyer, W. D., Ryll, E. D., and Crozier, D. Metabolic effects of intracellular infections in man. Ann. Intern. Med. 67:744, 1967.
Briscoe, J. The quantitative effect of infection on the use of food by young children in poor countries. Am. J. Clin. Nutr. 32:648, 1979.
Feigin, R. D. Interaction of nutrition and infection: Plans for future research. Am. J. Clin. Nutr. 30:1553, 1977.
Pollack, H., and Sheldon, D. R. The factor of disease in the world food problem. J. Am. Med. Assoc. 212:598, 1970.
Powanda, M. C. Changes in body balances of nitrogen and other key nutrients: Description and underlying mechanisms. Am. J. Clin. Nutr. 30:1254–1268, 1977.
Scrimshaw, N. S. Effect of infection on nutrient requirements. Am. J. Clin. Nutr. 30:1536–1544, 1977.
Keusch, G. T. The consequences of fever. Am. f. Clin. Nutr. 30:1211–1214, 1977.
Dossetor, J. F. B., and Whittle, H. C. Protein-losing enteropathy and malabsorption in acute measles enteritis. Br. Med. J. 2:592, 1975.
Spira, W. M., Saeed, Y. A., Khan, M. V., and Satar, M. A. Microbiological surveillance of intra-neighborhood E1 Tor cholera transmission in rural Bangladesh. Bull WHO 58:731–740, 1980.
White, G. F., Bradley, D. J., and White, A. V. Drawers of Water: Domestic Water Use in East Africa. University of Chicago Press, Chicago, 1972.
Palmer, D. L., Koster, F. T., Alam, A. K. M. J., and Islam, M. R. Nutritional status: A determinant of severity of diarrhea in patients with cholera. J. Infect. Dis. 134:8, 1976.
Koster, F. T., Aziz, K. M. A., Haque, A., and Curlin, G. T. Measles in Bangladesh: Synergy between measles, diarrhea, and malnutrition. In press, 1981.
Cash, R. A., Nalin, D. R., Rochat, R., Relier, L.B., Haque, Z. A., and Rahaman, A. S. M. M. A clinical trial of oral therapy in a rural cholera treatment center. Am. J. Trop Med. Hyg. 19:653, 1970.
Mahalanabis, D., Wallace, C. K., Kallen, R. J., Mondai, A., and Pierce, N. F. Water and electrolyte losses due to cholera in infants and children: A recovery balance study. Pediatrics 45:374–385, 1970.
Kielmann, A. A., and McCord, C. Home treatment of childhood diarrhea in Punjab villages. J. Trop. Pediatr. Environ. Child Health 23:195, 1977.
Mahalanabis, D., Choudhuri, A. B., Bagchi, N. G., Battacharya, A. K., and Simpson, T. W. Oral fluid therapy of cholera among Bangladesh refugees. Johns Hopkins Med. J. 132:197, 1973.
Morley, D. Paediatric Priorities in the Developing World. Butterworths, London, 1973.
Nalin, D. R., Cash, R. A., and Rahaman, A. S. M. M. Oral (or nasogastric) maintenance therapy for cholera patients in all age groups. Bull. WHO 43:361, 1970.
Walsh, J. A., and Warren, K. S. Selective primary health care: An interim strategy for disease control in developing countries. N. Engl. J. Med. 301:967–974, 1979.
Lindenbaum, J., Greenough, W. B., and Islam, M. R. Antibiotic therapy of cholera in children. Bull. WHO 37:529, 1967.
Blackburn, G. F., Flatt, J. P., Clowes, G. H. A., O’Donnell, T. F., and Hensle, T. E. Protein-sparing therapy during periods of starvation with sepsis or trauma. Ann. Surg. 177:588–594, 1973.
Lifshitz, F., Coelle-Ramirez, R., and Contreras-Gutierrez, M. L. The response of infants to carbohydrate oral loads after recovery from diarrhea. J. Pediatr. 79:612, 1971.
Lugo-de-Rivera, C., Rodriguez, H., and Torres-Pinedo, R. Studies on the mechanism of sugar malabsorption in infantile infectious diarrhea. Am. J. Clin. Nutr. 25:1248–1253, 1972.
Whitehead, R. G. Protein and energy requirements of young children living in the developing countries to allow for catch-up growth after infections. Am. J. Clin. Nutr. 30:1545–1547, 1977.
World Health Organization. Energy and Protein Requirements, Report of an FAO/WHO Ad Hoc Expert Committee, WHO Tech. Rep. Ser. No. 522. WHO Geneva, 1973.
Merson, M. H., Sack, R. B., Kibria, A. K. M. G., Mahmood, A., Adamed, O. S., and Huq, I. The use of colony pools for diagnosis of enterotoxigenic Escherichia coli diarrhea. J. Clin. Microbiol. 9:493–497, 1979.
Yolken, R. H., Wyatt, R. G., and Kapikian, A. Z. ELISA for rotavirus. Lancet ii:819, 1977.
Sack, D. A., Chowdhury, A. M. A. K., Eusof, A., Ali, M. A., Merson, M. H., Islam, S., Black, R. E., and Brown, K. H. Rehydration in rotavirus diarrhea: A double blind comparison of sucrose with glucose electrolyte solution. Lancet ii:280–284, 1978.
Blacklow, N. R., Dolin R., Fedson, D. S., DuPont, H., Northrup, R. S., Hornick, R. B., and Chansck, R. M. Acute infectious non-bacterial gastroenteritis: Etiology and pathogenesis. Ann. Intern. Med. 76:993, 1972.
Keusch, G. T. Subclinical malabsorption in Thailand. I. Intestinal absorption in Thai children. Am. J. Clin. Nutr. 25:1062–1066, 1972.
Klipstein, F. A., and Corcino, J. J. Factors responsible for weight loss in tropical sprue. Am. J. Clin. Nutr. 30:1703–1708, 1977.
Baker, S. J., and Mathan, V. I. Tropical enteropathy and tropical sprue. Am. J. Clin. Nutr. 25:1047–1055, 1972.
Ashworth, A. Growth rates in children recovering from protein-calorie malnutrition. Br. J. Nutr. 23:835, 1969.
Ashworth, A., Bell, R., James, W. P. T., and Waterlow, J. C. Calorie requirements of children recovering from protein-calorie malnutrition. Lancet ii:600, 1968.
Chandra, R. K. Immunological aspects of human milk. Nutr. Rev. 36:265–272, 1978.
World Health Organization. Report of a field trial by an international study group. A positive effect on the nutrition of Philippine children of an oral glucose-electrolyte solution given at home for the treatment of diarrhea. Bull. WHO 55:87, 1977.
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Chen, L.C. (1983). Interactions of Diarrhea and Malnutrition. In: Chen, L.C., Scrimshaw, N.S. (eds) Diarrhea and Malnutrition. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-9284-6_1
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DOI: https://doi.org/10.1007/978-1-4615-9284-6_1
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