Protracted diarrhea in infants and young children: a clinical evaluation with special reference to the role of infection
DOI:
https://doi.org/10.14238/pi22.5-6.1982.89-98Keywords:
protracted diarrhea, infection, malaria, amebiasis, E. coliAbstract
Since diarrheal disease is one of the IIwst prominent child health problem in Indonesia, a great deal of effort has been made to reduce morbidity and mortality rates of acute diarrhea.
Only a very small number of diarrheal cases, 49 oul of 1186 cases (4%) are protracted diarrhea, which can be divided into acute onset of protracted diarrhea without failure to thrive in 16 cases, chronic recurrent diarrhea with failure to thrive in 10, and chronic recurrent diarrhea without failure to thrive in 2 cases.
Malaria plays an important role in 10 cases of failure to thrive with protracted diarrhea, and in 3 acute onset of prolonged diarrheal cases without failure to thrive.
Amebiasis is found in 3 cases of acute onset of prolonged diarrhea. E. coli is found in 8 cases of acute onset of prolonged diarrhea without failure to thrive, in 2 cases of acute onset of prolonged diarrhea and failure to thrive, in 1 case of prolonged diarrhea in multiple congenital malformation and failure to thrive, and in 1 case of chronic recurrent diarrhea in colostomy and failure to thrive.
A massive dose of vitamin A is recommended to be given to all of the protracted diarrhea cases, since 6 out of 49 cases evidenced a marked vitamin A deficiency.
References
2. BROTOWASISTO: Epidemiology of Diarrhoea. Naskah lengkap Seminar Rehidrasi, Jakarta, Agustus 1174.
3. BURKE, V; KEERY, K.R; ANDERSON, C,M. The relationship of dietary lactose to refractory diarrhoea in infancy. Austr. Paediatr. J. 1:I 147 (1965).
4. CHALLACOMBE, D.N.; RICHARDSON, JM.; ROWE, B. and ANDERSON, C.M.: Bacterial microflora of the upper gastrointestinal tract in infants with protracted diarrhoea. Archs. Dis. Child. 49:270-277 (1974).
5. DE VILLE DE GO YET, C; SEAMAN, J. and GEIJER, U. The management of nutritional emergencies in large populations. WHO, Geneva, p. 91 (1978).
6. DRUCKER, M.M., et al. Entero Pa thogenic escherichia Coli in tissues of infants dying with enteritis. Paediatrics 46: 855 (1970).
7. DUPONT, H.L; FORMAL, S.B; HOR. NICK B.B; SAYDER, M.J; LIBONATI J.P; SEAMAN, D.G; LA BREL, L.H.
£lnd KACAS,J.P. Palhogenensis of Escherichia coli diarrhoea . New Engl. J. Med. 285 1 (1971).
8. GOLDMAN A.S; ANDERSON, D.W; SELLER W.A: SAPERSTEIN, S; KIKER W.T. and HALPERN, S.R: Milk allergy: Oral challenge with mi'lk isoIMed milk proteins in allergic children. Paediatrics 32 : 425 (1963).
9. GORBACH, S.L. and KHURANA, C,M,; Toxigenic Escherichia coli: a cause of infantile diarrhoea in Chicago. New. cy. Br. med. J. 1 : 1501-1504 (1976).
10. HARRISON, M: KILBY, A: SMITH, J.A.W: FRANCE, N.E and WOOD, G.B.S, : Cow's milk protein intolerance; a posslible association with gastroenteritis, lactose intolerance and IgA defidency. Br. Med. J. 1 : 1501 . 1504 (1976).
11. HEYWORTH, B and BROWN, I. Jejunal mcroflora in malnourished Gambian children. Archs. Dis. Child. 50 : 27-33 (1975).
12. KUITUHEN, P: VISAKORPI, J.K., SAVILAHTI, E. and PELKONEN, P.: Malabsorption syndrome with cow's milk intolerance : clinical findings and course in 54 cases. Archs. Dis. Childh. 50:351-356 (1975).
13. LARCHER, V.F: SHEPHERD, R: FRANCIS, D.E.M. and HARRIES, I.T,: Protracted diarrhea in infancy: Analysis of 82 cases with particular reference to diagnosis and management. Arc hs. Dis. Child. 52: 597-605 (1977).
14. LIFSHITZ, F: COELLO•RAMIREZ, P: GUTIERREZ• TOPETE, G. and CONTRERAS GUTIERREZ, ML. Monosaccharide intolerance and Hypogiicemia in infants with diarrhea. J. Pediatr. 77 : 595-603 (1970).
15. LLOYD•STILL, J.D.: SCHWACHMAN. H; and FILLER R.M.: Protracted Diarrhea of infancy treated by intravenous alimentation. Am. journ. Dis. Child. 125:358-364 (1973).
16. PHILIPS, J.A.: LOVEJOY, F.H. : Matsumiya, Yoichi: Ampicillin associated diarrhea. Pediatrics. 58: 869 (1976).
17. PITONO SUPARTO, HAROEN NURASID, and KWARI SUTIADlBRATA. Carbohydrate intdlcnmce in infants with chronic recurrent diarrhea. Paedialr. Indones. 17: 153-160 (1977).
18. SUNOTO. SUHARYONO: MANGIWA J. and SUTEJO: Lactose intolerance in chronic diarrhea among Indonesian children. Paediatr. Indones. 11: 1 (1971).
19. IYNGKARAN, N: DAVIS, K: ROBINSON, M.J.: BOEY, C.G: SUMITRAN, E: JADAV, M: l.AM, S.K. and PUTHUCHEARY, S.D.: Cow's milk protein sensitive enteropathy: an important contributing cause o[ seeondary sugar intolerance in young infants with acute infective enteritis. Archs, Dis, Child. 57: 39 (1979).
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