International Journal of Epidemiology 2000;29:916-921
© International Epidemiological Association 2000
Association between clinical type of diarrhoea and growth of children under 5 years in rural Bangladesh
a International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), GPO Box 128, Dhaka 1000, Bangladesh.
b Nutrition Program, ACITHN, University of Queensland, Brisbane, QLD 4029, Australia.
cDepartment of Pediatrics, LSU Medical School, 1542 Tulane Avenue, New Orleans, LA 70112, USA.
Reprint requests to: George J Fuchs MD, ICDDR,B, Centre for Health and Population Research, GPO Box 128, Dhaka 1000, Bangladesh. E-mail: gfuchs{at}icddrb.org
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 examined 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.
Keywords Bangladesh, children, diarrhoea, clinical type, dysentery, weight gain, height gain
Accepted 24 March 2000
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