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  • Title: Acute diarrhea in under five-year-old children admitted to King Mongkut Prachomklao Hospital, Phetchaburi province.
    Author: Suwatano O.
    Journal: J Med Assoc Thai; 1997 Jan; 80(1):26-33. PubMed ID: 9078814.
    Abstract:
    A prospective epidemiological and clinical study of acute diarrhea in children under 5 years old was done at King Mongkut Prachomklao Hospital in order to provide baseline data for health officers to make a strategic plan to reduce the diarrheal mortality and morbidity, which is one of the mid-decade goals for children. There were 105 cases of acute diarrhea patients admitted to the Pediatric ward between May 1995 and April 1996. Seventy-six per cent of them were in the younger age group (> 1 month-2 years old) while 23.8 per cent were in the older age group (2-5 years old). Causative pathogens were identified in 64 patients (61%). Younger patients had a higher percentage of identifiable pathogens (66.7%) than older patients (44.4%). Rotavirus was the most common pathogen isolated (17.2%). The other common pathogens identified were Eschericia coli (14.1%), Campylobacter jejuni (14.1%), Shigella (12.5%), Entamoeba histolytica (7.8%) and Salmonella (3.1%). Mixed infections were reported in 31.3 per cent of these patients. Clinical presentations and stool characteristics were difficult to distinguish from most of the pathogens. However, Rotavirus was highly suspected if a younger child presented with fever, watery to loose stool with the predominant symptom of vomiting. Mucous, mucous-bloody stool gave a clue to the diagnosis of Shigella and Entamoeba histolytica. Most cases had at least mild to moderate dehydration, so oral rehydration solution (ORS) was successfully given in only 31.4 per cent of patients. Antibiotics were prescribed to 51.4 per cent of patients in this study. Healthcare personnel should emphasize to parents and caretakers about good hygienic behavior to reduce the episodes of diarrhea and the use of ORS every time when their children have diarrheal episodes to reduce the disease severity. A prospective epidemiological and clinical study of acute diarrhea among children under age 5 years was conducted at King Mongkut Prachomklao Hospital to provide baseline data for health officers developing a strategic plan to reduce levels of diarrheal morbidity and mortality. 105 cases of acute diarrhea were admitted to the pediatric ward between May 1995 and April 1996. 76% were aged 1 month to 2 years; the rest were 2-5 years old. Causative pathogens were identified among 64, with pathogens identified among 66.7% of the younger children and 44.4% of the older children. Rotavirus was the most common pathogen isolated (17.2%), followed by Escherichia coli (14.1%), Campylobacter jejuni (14.1%), Shigella (12.5%), Entamoeba histolytica (7.8%), and Salmonella (3.1%). Mixed infections were reported in 31.3% of the patients. There was not much difference between clinical presentations and stool characteristics for most of the pathogens. Since most cases had at least mild to moderate dehydration, oral rehydration solution was successfully given in only 31.4% of cases and antibiotics were prescribed to 51.4% of patients.
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