Association between clinical type of diarrhoea and growth of children under 5 years in rural Bangladesh
Alam, D.S.; Marks, G.C.; Baqui, A.H.; Yunus, M.; Fuchs, G.J.
International Journal of Epidemiology 29(5): 916-921
2000
ISSN/ISBN: 0300-5771 PMID: 11034978 DOI: 10.1093/ije/29.5.916Document Number: 572073
Background: The role of diarrhoea in the aetiology of growth retardation in young children remains controversial. To evaluate this, a population-based, longitudinal study of young children aged 6-48 months was conducted in Matlab, a rural area of Bangladesh, between May 1988 and April 1989. Methods: Data obtained from 584 children were exammed by one-year (n = 412) and 3-month (n = 1220) growth periods. Each growth period was analysed based on clinical types of diarrhoea, namely, non-diarrhoea, non-dysentery diarrhoea (diarrhoea without blood), and dysentery (diarrhoea with blood). Weight and height gains were compared among the study groups initially by one-way analysis of variance followed by multivariate analysis adjusting for potential confounding variables. Results: Compared to non-diarrhoea and non-dysentery diarrhoea, dysentery was associated with significantly lower annual weight gain (1866 g (P < 0.01) and 1550 g (P < 0.05) versus 1350 g, respectively) and height gain (6.51 cm and 5.87 cm versus 5.27 cm. (P < 0.01), respectively). Both 3-month dysentery and non-dysentery intervals were significantly associated with less weight gain compared to non-diarrhoea intervals (490 g and 522 g versus 637 g (P < 0.05), respectively). Dysentery intervals were also associated with significantly poorer height gain compared to other intervals (2.19 cm versus 2.42 cm (P < 0.05) and 2.46 cm (P < 0.01), respectively). Conclusions: The growth of young children is strongly influenced by the clinical type of diarrhoea and the impact is dependent on the proportion of dysentery episodes in the total diarrhoeal burden.