Persistent diarrhoea: associated infection and response to a low lactose diet
Ashraf, b.H.; Ahmed, S.; Fuchs, G.J.; Mahalanabis, D.
Journal of Tropical Pediatrics 48(3): 142-148
2002
ISSN/ISBN: 0142-6338 PMID: 12164597 DOI: 10.1093/tropej/48.3.142Document Number: 242373
Children aged 4-23 months from Bangladesh with persistent diarrhoea received a low lactose diet, multivitamins, minerals and antibiotics for infection . Sixty-one (57%) children improved with low lactose diet while 46 (43%) failed. Children who failed were younger (8.9+or-3.5 vs. 11.3+or-4.4 months), had higher initial purging rate (146+or-102 vs. 109+or-102 g/kg/day) and consumed more ORS (138+or-77 vs. 95+or-79 g/kg/day). A higher proportion of children in the failure group needed unscheduled intravenous fluid (48 vs. 20%) and lost body weight (24 vs. 0%). Single and multiple faecal pathogen were isolated from 44 and 45% cases, respectively. Diarrhoeagenic Escherichia coli (66%) was the most common pathogen isolated. Half of all pathogens including Campylobacter, rotavirus, cholera and non-typhoidal Salmonella were nosocomially acquired. Sixty four percent of children had extraintestinal infections including acute lower respiratory infection (50%), urinary tract infection (29%) and septicaemia (11%). The presence of extraintestinal infections were significantly associated with failure. Overall, 91% of children had either intestinal and/or extraintestinal infections.