Aim:
The aim of the study is to determine the Clinical profile, Etiology of diarrhoea >2weeks duration in children between 1mon-12yrsof age in tertiary centrein South India
Objective:
To find the common causes of chronic diarrhoea in our hospital and to findout the most useful methods for diagnosis
Introduction:
Chronic diarrhoea defined as diarrhoea lasting for more than 14 days. The epidemiology has two distinct patterns: In developing countries persistence of infection either
gut or extra gut,malnutrition associated diarrhoea, where as in developed countries chronic diarrhoea is less frequent and the aetiology often varies with age.The outcome of diarrhoea depends on the cause and ranges from benignself-limited to severe congenital disease,that may lead to progressive intestinal failure
Study justification:
Chronic childhood diarrhoea had variety of etiologies, a specific diagnosis could be established in 90% of cases, by various diagnostic tests, so that appropriate therapy can be
instituted to reduce morbidity and mortality.
Methodology
(Materials& methods)
1.Study design: Prospective Study
2.Study population:Children in study age group attending gastroenterology
department and admitted in medical ward, satisfying the inclusion criteria.
3.Place of study: Department of gastroenterology and paediatric medical ward in ICH
4.Study period: October 2016 to September 2017
5.Sample size: 43
6.Inclusion criteria: All children aged 1 month to 12years presenting with diarrhoea >2 weeks attending the hospital
7.Exclusion criteria:children with established diagnosis treatment
Procedure:
After obtaining informed consent from parent/guardian, various patient demographic
characteristics, history, clinical details,anthropometry, will be entered in a pre structured
Proforma. All these children will have basic investigations like CBC, peripheral smear, Blood
sugar,RFT, Sr.electrolytes,Urine routine, X ray chest,USG,HIV,stool routine and second line
investigations include upper GI endoscopy,barium contrast studies &colonoscopy for cases
suspected to have tuberculosis, Inflammatory bowel disease. Sigmoidoscopy and biopsy in
case of Cow`s milk protein allergy.
Statistical Analysis:
Data will be entered in excel sheet. Statistical analysis of data will be performed by
statistical software SPSS. Outcome variables will be categorized as normal or abnormal and
their prevalence will be expressed as percentage and p value of <0.05 will be considered
significant.
Results:
In this study age wise distributionof chronic diarrhoea results were: 21 children (48.8%) aged < 1yr, 17 children(39.5%) aged between 1- 5 yrs and 5 children (11.7%)
belongs to more than 5 yrs Mean age of onset of diarrhoea in our study were 23 months ranging from 1 month to 120 months
Malnutrition distribution of our study were 62.7% .Of which 16 children had severe acute malnutrition (37.2%), 8 children had moderate acute malnutrition (18.5%), and 3 children aged above 5 yrs with severe underweight (7%).
Etiological Results of this study were, intestinal infections(25.58%), Cows milk protein allergy(20.93%),Inflammatory bowel disease (4.65%), congenital zinc deficiency (2.33%), congenital tufting enteropathy (2.33%), intestinal lymphangiectasia (2.33%), malabsorbtion (2.33%), secondary lactose intolerance(2.33%), severe combined immunodeficiency(2.33%) and idiopathic (34.88%) In this study out of 43 children, 42 (97.7%) children were improved with treatment and 1(2.3%) child was died(severe combined immunodeficiency).
Conclusion
1. Mean age of onset of chronic diarrhoea in this study was 23 months ranging from 1month -120 months.
2. Most common age group affected in this study was < 1yr of age (48.8%).
3. Male children were more commonly affected (58.1%) than female children (41.9%). Male /female ratio were 1.4:1.
4. Rural children (79.1%) are more commonly affected than Urban (20.9%) children.
5. 5.Small bowel diarrhoea (72.1%) were more common than Large bowel diarrhoea (27.9%).
6. In our study Malnutrition were observed in 62.7% children
7. Commonest cause of chronic diarrhoea in our study was intestinal Infections (25.58%), followed by cow’s milk protein allergy(20.93%).
8. Outcome: Children improved with treatment were (97.7%). One child (2.3%) was died (SCID
