Dysentry in children under five year of age: a longitudinal prospective study in primary health care in Indonesia

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Yati Soenarto
Achmad Suryono
Suharyanto Supardi


We conducted a longitudinal community-based survey between August 1991 and August 1992 started with a pilot study in May 1991 in two rural villages which involved 497 children aged 0-59 monhs, 58 community health workers (CWHs), 44 community representatives, and 5 health center personnel. The qualitative component was carried out using in-depth interviews with the mothers, CWHs, and health personnel. It appeared that the three terms for diarrhea used in the
community were similar to medical terminology. However the community perception was that only cases of diarrhea with dehydration should be referred to the health center (HC) for tretment; bloody diarrhea was not considered to be referred. Through case findings, 168 (33.8%) diarrheal episodes were identified among 141 children (1.2 episodes per child). Twenty-two of 168 cases (13.1%) had bloody stool, shigella was isolated in 9 (41%) of these patients. No death occurred in this study. Diagnostic agreement on bloody and watery stool specimens between HC personnel and CHWs was analyzed using data from the 72 stool specimens that were seen by both parties, which showed a kappa coefficient of 0.50. Breast feeding (90%) nand additionalk food (89%) were given during diarrhea in almost all cases. Oral rehydration salts solution was given in 80% odf cases. The study shows that the existing treatment guidelines in the HCs were not properly followed by the health personnel.

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How to Cite
Soenarto Y, Suryono A, Supardi S. Dysentry in children under five year of age: a longitudinal prospective study in primary health care in Indonesia. PI [Internet]. 30Jun.2001 [cited 14Nov.2019];41(5-6):141-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1096
Received 2016-12-05
Accepted 2016-12-05
Published 2001-06-30


1. Sutoto. The progress in the control of diarrheal disease program in Indonesia (as of 1991) in International Symposium on RCH, Family Planning and diarrheal disease, 1996.
2. Henry FJ, Alam N, Aziz KM, Rahaman MM. Dysentery, not watery diarrhea, is isolated with stunting in Bangladeshi children. Hum Nutr Clin Nutr 1987; 41:243-9.
3. Bhan MK. Management of dysentery and prolonged diarrhea. proceeding 3rd International conference on oral rehydraion therapy. Washington 1988. p. 78-84.
4. WHO. The management of bloody diarrhea in young children. WHO/CDD/94.49. Geneva 1994.
5. Sutoto. Diarrheal disease data from Indonesia. BEPID 1989; :136-8.
6. WHO. The treatment of diarrhea. A manual for physicians and
other senior health workers. WHO/CDR/95.3. Geneva 1995.
7. Nichter M. Use of social science research to improve epidemiologic
studies of and intraventions for diarrhea and dysentery. Rev of Infect Dis 13 (Suppl 4): S265-71.
8. Stoll BJ, Glass RI, Banu HMI, Khan MU, Ahmed M. Value of stool examination in patients with diarrhoea. Brit Med J 1983; 286:2037-40.
9. Ministry of Health Republic of Indonesia. Jakarta: MOH Indonesia.
Primary Health Care in Indonesia. Published by Ministry of Health Directorate General for Community Health Directorate of Community Participation. 1990, 1st May.
10. WHO. Programme for the control of diseases. Guidelines for control of epidemics due to Shigella dysentery type I. WHO/CDD/93.45. Geneva 1983.
11. Choudhury AMR, Cash RA. A simple solution: reaching millions to treat diarrhea at home. Bangladesh University Press 1996.
12. Dibley MJ, Sadjimin T, Kjolhede CL, Moulton LH. Vitamin A supplementation fails to reduce incidence of acute respiratory illness and diarrhea in preschool-age Indonesian children. J Nutr 1996; 126:434-42.
13. WHO. Program for control of diarrheal disease. In: Manual for laboratory investigations of acute enteric infections. WHO/CDD/83.3. Rev 1. Geneva 1987.
14. WHO. Guidelines for the control of epidemics due to Shigella dysenteriae. WHO/CDD/88.12. Geneva 1988.
15. Kramer MS, Feinstein AR. The biostatistics of concodance. Clin Pharmacol Ther 1981; 29:111-23.
16. Zeitlyn S, Islam F. The use of soap and water in two Bangladeshi communities: Implications for the transmission of diarrhea. Rev Infect Dis 13 (Suppl 4):S259-64. Geneva 1991.
17. Bern C, Martines J, de Zoysa I, Glass RI. The magnitude of the global problem of diarrheal disease: a ten-year update. Bull WHO 1992; 70(6):705-14.
18. Baqui AH, Black RE, Sack RB, Yunus MD, Siddique AK, Chowdhury HR. Epidemiological and clinical characteristics of acute and persistent diarrhea in rural Bangladeshi children. Acta Pediatr Suppl 1992; 381:15-20.
19. Sutoto, Indriyono. Kebijaksanaan operasional pembatasan disentri dalam program pembatasan penyakit diare. Policies on the control of diarrheal diseases in the fifth five years development program. Maj Kedok Indon 1991; 41:259-64.
20. El Samani FZ, Willet WC, Ware JH. Association of malnutrition
and diarrhea in children aged under five years. A prospective follow-up study in a rural Sudanese community. Am J Epidemiol 1988; 128:93-105.
21. Luna AAM, Fang G, Schorling JB, McAuliffe JF, de Souza MA. Diarrhea in Northast Brazil: etiologies and interactions with malnutrition. Acta Pediatr Suppl 1992; 38:39-44.
22. Hutley SRA, Hoque BA, Aziz KMA, Hasan KZ, Patwary MY, Rahaman MM, Feachem RG. Persistent diarrhea in a rural area of Bangladesh: a community-based longitudinal study. int J Epidemiol 1989; 9:25-33.