Acute diarrhea and malnutrition: Lethality risk in hospitalized infants

Acute diarrhea and malnutrition: Lethality risk in hospitalized infants

Author Fagundes-Neto, Ulysses Autor UNIFESP Google Scholar
Andrade, Jacy Alves Braga de Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objectives: Acute diarrhea is a very frequent disease in developing countries and is the first cause of death in infants under two years of age. This study was designed to evaluate the clinical and epidemiological factors associated to the death of 17 out of 511 infants hospitalized due to severe acute diarrhea between January 1989 and December 1995.Patients and Methods: The patients were divided into two groups according to their clinical evolution: Group I-Death and Group II-Survival. The following parameters were evaluated: birth weight, gender, age, duration of diarrhea (days) prior to admission, nutritional status, hydration, presence of an enteropathogenic agent in the stools, food intolerance and duration of hospitalization.Results: The analyzed factors have shown a significant association with death for the following variables: age, relative factor of death (RFD)=4.0 for infants less than six months of age, identification of an enteropathogenic Escherichia coli (EPEC) strain in the stools (RFD=3.3), severe malnutrition at admission to the hospital (RFD=4.5), occurrence of food intolerance during hospitalization (RFD=2.7). Some enteropathogenic agent was identified in the stools of 253 infants (54.9%), among the 461 (90.2%) studied. Group I revealed the presence of an enteropathogenic agent in 75% of the cases. The most frequent agents identified in Group I were: EPEC (56.3%) and Shigella (12.5%), while in Group II EPEC was identified in 26.5% of the patients.Conclusions: The association of some factors, such as age less than six months, severe malnutrition, food intolerance and the identification of EPEC strains in the stool culture, indicate a high risk of death in infants hospitalized due to severe acute diarrhea.
Keywords acute diarrhea
enteropathogenic Escherichia coli
Language English
Date 1999-08-01
Published in Journal Of The American College Of Nutrition. New York: Amer Coll Nutrition, v. 18, n. 4, p. 303-308, 1999.
ISSN 0731-5724 (Sherpa/Romeo, impact factor)
Publisher Amer Coll Nutrition
Extent 284-288
Access rights Closed access
Type Article
Web of Science ID WOS:000081786900003

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