Diarrhea in developed and developing countries: magnitude, special settings, and etiologies
Guerrant, R.L.; Hughes, J.M.; Lima, N.L.; Crane, J.
Reviews of Infectious Diseases 12(Suppl 1): S41-S50
1990
ISSN/ISBN: 0162-0886 PMID: 2406855 DOI: 10.1093/clinids/12.supplement_1.s41Document Number: 371173
Diarrhea is the 2nd most frequent illness in the world. In a study done in Cleveland, Ohio from 1948-1957, researchers learned that people had diarrhea an average of 1.52 times annually. The age specific attack rates climbed from 1 episode/child 1 year old/years to 2-2.2 episodes/child 1-10 years old/year. In similar study in Charlottesville, Virginia between August 1975-July 1977, the overall diarrhea attack rate stood at 1.9 episodes/person/year and, for children 3 years old, it was 2.5 episodes/year. The incidence of diarrhea peaked in the winter months, unlike developing countries where it peaks in the summer months. In developing countries, attack rates range from 5-12 episode/child/year with the highest rates in the 1st 2 years of life (e.g., in India among the urban poor, 18.6 episodes/child/year. diarrhea stands as the leading cause of death in developing areas. Even though oral rehydration therapy is reducing the morality rate from acute diarrhea in developing countries, prolonged episodes of diarrhea of 14- 20 days continue to claim children's lives. In developed countries, diarrhea poses a distinct problem to hospitals, nursing homes., and day care enters. For example, researchers revealed 7.7 cases of nosocomial diarrhea/100 admissions in the medical intensive care unit at the University of Virginia Hospital. About 33% of the elderly patient in extended care facilities have a serious diarrheal illness each year. Reports show that attack rates among children in child care facilities range from 17-100% with considerable secondary attack rates in the children's families. People with AIDS often experience diarrhea which for them is often fatal. In the United State, 50-60% of them have it at diagnosis while in Africa and Haiti the percentage is 95%.