Characteristics of Children Hospitalized with Severe Dehydration and Persistent Diarrhoea in Bangladesh (Report‪)‬

INTRODUCTION Persistent diarrhoea, defined as episodes of acute diarrhoea lasting for 14 days or more (1), accounts for only about 3-20% of all diarrhoeal episodes (2-4). Since its case-fatality rate is as high as 60% (5-8), the problem has drawn attention of the clinicians and epidemiologists to develop effective treatment strategy. A number of studies (9-18) have described the epidemiology, aetiology, risk factors, and clinical management of persistent diarrhoea. Unfortunately, reports on its clinical features, in terms of spectrum of disease severity, are inadequate. One report (19) has described two major clinical categories of persistent diarrhoea: (a) mild persistent diarrhoea with several daily loose stools, normal hydration status, and growth-faltering leading to more severe malnutrition, and sometimes, death due to diarrhoea or other illnesses and (b) severe persistent diarrhoea with dehydration due to a high purging rate (7 mL/kg.h or very frequent large watery stools). Recently, in a WHO document (20), persistent diarrhoea has been classified on the basis of presence of dehydration either into persistent diarrhoea (with no dehydration) or severe persistent diarrhoea (with dehydration). It is obvious that patients with severe persistent diarrhoea need hospitalization. However, none of the studies has identified potential risk factors to predict the development of severe illness and whether severity is preventable by awareness of the caregivers or improved case management during an acute diarrhoeal episode. The present study was designed to document different clinical characteristics in young children presenting with persistent or severe persistent diarrhoea.