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Treatment outcome of children with persistent Diarrhoea admitted to an Urban Hospital, Dhaka during 2012–2013

机译：2012-2013年间达卡城市医院住院的持续腹泻儿童的治疗结果

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Background Despite availability of treatment guidelines, persistent diarrhoea (PD) has been a major contributor of diarrhoeal deaths in low and middle income countries. We evaluated the outcome of children under the age of 5 years who were treated for PD using management algorithm with locally available foods in a diarrhoeal disease hospital in Dhaka. Methods We extracted retrospective data from electronic database for all the under-five children admitted for PD in the Longer Stay Ward and Intensive Care Unit of the Dhaka hospital at icddr,b between 2012 and 2013. Descriptive analysis was done to explore available baseline socio-demographic, nutritional, and co-morbid statuses, pathogens from stool isolates, duration of treatment, use of antibiotics, duration of hospital stay and treatment success rates. We sought to investigate above mentioned descriptive features in addition to associated factors with time to recover from PD using survival analysis with Cox proportional hazard model. Results A total number of 426 children with a median age of 7.46 (inter-quartile range IQR; 5.39, 9.43) months were admitted for PD during the study period. Of these, 95% of children were recovered from PD and discharged from the hospital. The median duration of treatment response was 6 (IQR 4, 9) days. The case fatality rate was 1.17%. Multivariate analysis among the children of 6 months or less showed that the rate of recovery from PD was 57% lower in children with severe stunting compared to those without severe stunting (HR 0.43, 95% CI 0.22, 0.88, p Conclusion The treatment guideline for persistent diarrhoea patients followed at icddr,b Dhaka hospital was found to be successful and can be used in other treatment facilities of Bangladesh and other developing countries where any treatment algorithm for PD is unavailable. More emphasis is required to be given for the prevention of hospital acquired infection that may help to limit the use of antibiotic in order to enhance the recovery rate from PD.
机译：背景技术尽管有治疗指南，但持续性腹泻（PD）一直是中低收入国家腹泻死亡的主要诱因。我们评估了在达卡腹泻病医院使用管理算法结合当地可用食品对5岁以下儿童进行PD治疗的结局。方法我们从电子数据库中提取了2012年至2013年间在icddr，b达卡医院达卡医院长住病房和重症监护室接受PD治疗的所有5岁以下儿童的回顾性数据。人口，营养和合并症状态，粪便分离株的病原体，治疗持续时间，抗生素的使用，住院时间和治疗成功率。我们试图使用Cox比例风险模型进行生存分析，研究上述描述性特征以及相关因素以及从PD中恢复的时间。结果在研究期间，共纳入426名中位年龄为7.46（四分位间距IQR; 5.39、9.43）个月的儿童进行PD。其中，95％的儿童从PD康复并出院。中位治疗反应持续时间为6（IQR 4，9）天。病死率是1.17％。对6个月或更短的儿童进行多变量分析表明，严重发育迟缓的患儿与没有严重发育迟缓的患儿相比，PD的恢复率降低了57％（HR 0.43，95％CI 0.22，0.88，p结论发现在icddr，b达卡医院进行的持续腹泻患者是成功的，可用于孟加拉国和其他发展中国家的其他无法使用PD治疗方法的治疗机构，需要更加重视预防医院获得性感染，可能有助于限制抗生素的使用，以提高PD的恢复率。

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