• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권sup1호
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• pp.53-61
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• 2009

The mainstay in the management of mild to moderately dehydrated children is fast rehydration by using hypotonic ORS (oral rehydration solution) and complete resumption of normal diet, including lactose-containing formula after 4 hours rehydration. Since the majority of young children with uncomplicated acute diarrhea will tolerate large amounts of undiluted non-human milk, withholding food and milk from children during diarrhea is not recommended anymore, regarding time to resolution and diarrhea control. In addition, routine dilution of milk and routine use of lactose-free formula are not necessary after fast ORS therapy. Breastfed infants and children fed with solid foods may safely continue receiving their usual diets during diarrhea instead of gradual reintroduction of feeding. However, young infants or children with severe diarrhea or malnutrition should be carefully treated under supervision if fed with lactose containing, non-human milk exclusively.

• Parasites, Hosts and Diseases
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• 제59권1호
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• pp.61-65
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• 2021

Diarrheal disease is the second leading cause of mortality and morbidity in children under 5 years old worldwide, and is the most common cause of malnutrition in sub-Saharan Africa. In Rwanda, diarrhea is the third leading cause of death in children under 5 years old. This study examined the association between sociodemographic factors and diarrhea in children under 5 years using the data of 7,474 households in the 2014-2015 Rwanda Demographic and Health Survey. Overall prevalence of diarrhea in this study was 12.7% in children. An increased risk for diarrhea was found for children aged 12-23 months (odds ratio (OR)=4.514), those with a low economic status (OR=1.64), those from the Western province (OR=1.439), those with poorly-educated mothers (OR=5.163), and those with families engaged in agricultural activities (OR=1.624). In conclusion, sociodemographic factors significantly affect the risk of developing diarrhea in children under 5 years in Rwanda. Designing and implementing health education promoting awareness of early interventions and rotavirus vaccination are essential to reduce diarrheal diseases for the Rwandan community.

• Journal of Microbiology and Biotechnology
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• 제28권4호
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• pp.652-662
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• 2018

Diarrhea is a global disease with a high morbidity and mortality rate in children. In this study, 25 fecal samples were collected from children under 5 years old. Seven samples had been taken from healthy children without diarrhea and marked as the healthy control group; eight samples had been sampled from children with diarrhea caused by dyspepsia and defined as the non-infectious group; and ten samples had been taken from children with diarrhea induced by intestinal infections and identified as the infectious group. We detected the microbial communities of samples by using high-throughput sequencing of 16S rRNA genes. The proportion of aerobic and facultative anaerobic microbes in samples of the infectious group was much higher than in the non-infectious group. In addition, the relative abundance of Enterococcus in the healthy control group was significantly higher than in the non-infectious group and infectious group. This can be used as a potential diagnostic biomarker for diarrhea.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권3호
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• pp.242-248
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• 2019

Purpose: Severe acute malnutrition (SAM) is an important public health problem which contributes to significant number of under five deaths. Protocol based management significantly decreases risk of deaths in children with medical complications. Methods: Outcome of children aged 2 months-5 years admitted and fulfilling definition of SAM having diarrhea (group A) was compared to children with SAM having medical complications other than diarrhea (group B). Both groups were managed according to standard recommended protocols and monitored and followed up for 12 weeks after discharge. Results: The average weight gain, defaulter rate, primary failure, secondary relapse rate and readmission rate were similar in both groups. Length of stay in group A was three days longer (p-value=0.039). Discharge rate was comparable with overall 68% of children successfully discharged and 50% of children reaching weight/height > -2 standard deviation at follow-up of 12 weeks. Conclusion: The current management protocol is equally effective for managing children with SAM having diarrhea. Good adherence to management protocol of dehydration and timely modification of therapeutic feeds in children with persistent diarrhea results in satisfactory weight gain.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권2호
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• pp.95-103
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• 2024

Purpose: Diarrhea is one of the leading causes of mortality in children living in developing countries. The etiology of acute diarrhea in each healthcare center varies depending on place, time, and population. This study aimed to identify pathogen patterns in human immunodeficiency virus (HIV)-infected and non-HIV children suffering from acute diarrhea, using multiplex real time reverse transcriptase polymerase chain reaction (RT-PCR), in an Indonesian tertiary hospital. Methods: This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital from March 2019 to April 2020. Results: The study showed that multiplex RT-PCR results were positive in 58.9% of the specimens, with more positive results in HIV-infected children than in non-HIV-infected children (70% vs. 54.7%). Altogether 72 enteropathogens were detected from all specimens. Enteropathogens in non-HIV children with acute diarrhea consisted of bacteria (70.6%) and viruses (29.4%) with a predominance of enteroaggregative Escherichia coli (25.4%), followed by Campylobacter spp. (11.8%), enteropathogenic E. coli (9.8%), Norovirus GII (7.8%), and Clostridium difficile (7.8%). Enteropathogens in HIV-infected children consisted of viruses (57.1%), bacteria (28.6%), and parasites (14.3%) comprising Norovirus GII (24%), Cryptosporidium spp. (14.3%), Campylobacter spp. (14.3%), Norovirus GI (14.3%), and Astrovirus (14.3%). Cryptosporidium spp. was the only parasite found in this study and was found only in HIV-infected children. In non-HIV children with acute diarrhea, most pathogens were invasive bacteria, while in HIV-infected children, more viral and parasite infections occurred, primarily caused by opportunistic pathogens. Conclusion: The pattern of enteropathogens can help clinicians determine further examinations and appropriate empirical antimicrobial therapy for the patient.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권sup1호
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• pp.93-97
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• 2009

Worldwide, diarrhea remains one of the most common illnesses among children. Oral rehydration therapy (ORT) is the cornerstone of diarrhea treatment. Yet, the rates at which ORT is used are still disappointingly low. Additional treatment interventions include antimotility drugs, antisecretary drugs, adsorbents, probiotics, antibiotics, oral immunoglobulin, micronutrient supplementation. Drugs are generally not necessary. However, selected probiotics may reduce the duration and intensity of diarrhea. Zinc is beneficial especially to malnourished children with diarrhea. Antibiotic treatment is effective mainly in shigella and cholera infection. Other drugs may be effective but require further investigations.

• 대한한방소아과학회지
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• 제18권2호
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• pp.1-9
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• 2004

Objectives: The objective of this study is to assess the clinical effect of Gagamjeonsibaekchul-san on child diarrhea. Methods: This clinical study was carried out with 42 cases(31male, 11female) of children aged 0 to 14 years old who visited the Department of Pediatrics, Dongguk University Bundang Oriental Hospital and were diagnosed as the diarrhea. Assessments were made with reference to sex, age, the duration of symptoms and physical history. To assess the impact of Gagamjeonsibaekchul-san, the complicated signs, the duration of treatment, the correlation between the use of Gagamjeonsibaekchul- san, san and the duration of symptom were examined before and after the treatment. Results: There were 31 males and 11 females in the incidence by sex. It showed that males were more than females. The most numerous age group was 0-2(19) followed by 3-7 (11) and 9-12 (12). According to the duration of symptom, 12 children have symptom for 0-7 days, 10 for 8-14 days, 11 for 15-20 days, 4 for 22-28 days and 5 over 28 days. With regard to the physical history of the sample, 5 children had atopic dermatitis, 3 children had enteritis, 3 children had rhinitis, 2 children had tonsillitis, 1 child had otitis media, 1 child had asthma and 1 child had pneumonia. The children also had the complicated signs: 22 children had anorexia, 17 children had abdominal pain, 13 children had vomiting and 8 children had nausea in digestive organ. In addition 11 children had dizziness, 7 children had general weakness, 1 child had enuresis and 1 child had sweat in general symptoms. For the duration of the treatment, 14 children were treated for 7 days, 13 for 8-10 days, 8 for 11-14 days, 3 for 15-21 days, 2 for 22-28 days and 2 for 29-40 days. No distinct relationship between the use of Gagamjeonsibaekchul-san and the duration of the symptom was found. Conclusion: Gagamjeonsibaekchul-san is effective in the treatment of intestine mucous membrane and improves the function of digestive system. It is also an effective short-term treatment for child diarrhea.

• 대한한방소아과학회지
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• 제18권2호
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• pp.11-11
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• 2004

Objectives: The objective of this study is to assess the clinical effect of Gagamjeonsibaekchulsan on child diarrhea. Methods: This clinical study was carried out with 42 cases(31male, 11female) of children aged 0 to 14 years old who visited the Department of Pediatrics, Dongguk University Bundang Oriental Hospital and were diagnosed as the diarrhea. Assessments were made with reference to sex, age, the duration of symptoms and physical history. To assess the impact of Gagamjeonsibaekchulsan, the complicated signs, the duration of treatment, the correlation between the use of Gagamjeonsibaekchul- san and the duration of symptom were examined before and after the treatment. Results: There were 31 males and 11 females in the incidence by sex. It showed that males were more than females. The most numerous age group was 0-2(19) followed by 3-7 (11) and 9-12 (12). According to the duration of symptom, 12 children have symptom for 0-7 days, 10 for 8-14 days, 11 for 15-20 days, 4 for 22-28 days and 5 over 28 days. With regard to the physical history of the sample, 5 children had atopic dermatitis, 3 children had enteritis, 3 children had rhinitis, 2 children had tonsillitis, 1 child had otitis media, 1 child had asthma and 1 child had pneumonia. The children also had the complicated signs: 22 children had anorexia, 17 children had abdominal pain, 13 children had vomiting and 8 children had nausea in digestive organ. In addition 11 children had dizziness, 7 children had general weakness, 1 child had enuresis and 1 child had sweat in general symptoms. For the duration of the treatment, 14 children were treated for 7 days, 13 for 8-10 days, 8 for 11-14 days, 3 for 15-21 days, 2 for 22-28 days and 2 for 29-40 days. No distinct relationship between the use of Gagamjeonsibaekchul-san and the duration of the symptom was found. Conclusion: Gagamjeonsibaeichul-san is effective in the treatment of intestine mucous membrane and improves the function of digestive system. It is also an effective short-term treatment for child diarrhea.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권2호
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• pp.162-170
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• 2019

Purpose: The aim of this study was to analyze the effects of probiotics and zinc supplements on the mean duration and frequency of acute diarrhea in children aged 6 months to 2 years. Methods: In this clinical trial of infants aged between 6 months and 2 years, eligible patients were divided into 3 groups: Zinc Receiving Group (ZRG), Probiotic Receiving Group (PRG), and a control group receiving supportive care alone. The frequency of diarrhea was evaluated in the test groups during the first 24 hours and 48-72 hours, along with the duration of hospitalization and diarrhea persistence for 3-7 days. Results: Diarrhea persisted for until the third day of admission in 100% of the infants in PRG compared with only 76.1% in ZRG. The relative risk of diarrhea persistence in the PRG was 1.31 times more than in ZRG until the third day. Also, 80% of diarrhea cases in the PRG persisted until the fourth day of admission, compared with 47.8% in the ZRG group, and this value was significant. The relative incidence of diarrhea persistence in the PRG was 36.4 times greater than in the ZRG until the day 4. Also, the percentage of post-treatment complications was 35.5% in the PRG and 2.6% in the ZRG, which was significant. Conclusion: In our study, the effectiveness of zinc at a dose of 20 mg was higher than that of probiotics. The complications associated with zinc supplementation were lower than those of probiotics.

• Parasites, Hosts and Diseases
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• 제52권5호
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• pp.479-485
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• 2014

Cryptosporidium diarrhea represents a relevant clinical problem in developing countries. In Al-Taif, a city of Saudi Arabia that lies at an altitude of an around 2 km above the sea level, Cryptosporidium infection seems to be undiagnosed in nearly all clinical laboratories. Furthermore, nothing was published regarding Cryptosporidium-associated diarrhea in this area. The objectives of this research were to (1) determine the Cryptosporidium prevalence among patients with diarrhea and (2) to estimate the performances of 3 different diagnostic methods. Total 180 diarrheal fecal samples, 1 sample per patient, were collected between January and August 2013. Samples were screened for Cryptosporidium with modified Zeihl Neelsen (ZN) microscopy, $RIDA^{(R)}$ Quick lateral flow (LF) immunotest, and a previously published PCR. The Cryptosporidium prevalence rate was 9.4% (17/180), 10% (18/180), and 11.6% (21/180) by microscopy, LF, and PCR test, respectively. Infection was significantly (P=0.004) predominant among children <5 years (22%) followed by children 5-9 years (11.1%). Although infection was higher in males than in females (16.2% males and 8.5% females), the difference was not statistically significant (P=0.11). Compared to PCR, the sensitivity of microscopy and the LF test were 80.9%, 85.7%, respectively. To conclude, high Cryptosporidium-associated diarrhea was found in this area especially in children ${\leq}9$ years. The PCR test showed the best performance followed by the LF test and ZN staining microscopy. The primary health care providers in Al-Taif need to be aware of and do testing for this protozoon, particularly for children seen with diarrhea.