The goal of a new study published in Tropical Medicine and International Health was to determine the pathogen specific risk of seizure in children under-five, hospitalized with moderate-to-severe diarrhea (MSD) in rural settings.

This was a prospective case-control study with follow-ups conducted in a sentinel facility of Global Enteric Multicenter Study in Mirzapur, Bangladesh, between 2007 and 2010. Overall, 64 children aged 0-59 months who presented with MSD and seizure constituted the cases, whereas those who did not have seizure (128 randomly selected children) comprised the controls. MSD was defined if the episodes were associated with dehydration or dysentery or required hospitalization with diarrhea or dysentery. All children were followed-up at home within 50-90 days of enrollment.

It was found that shigellosis – Shigella species, particularly S. flexneri and S. sonnei; norovirus; fever; and loss of consciousness were independent risk factors for seizure in MSD children. At enrollment cases had lower WHZ compared to their peers. Follow-up anthropometrics showed significant improvement in WHZ and WAZ; whereas deterioration in HAZ was noted in both, cases and controls.

It was concluded that childhood MSD episodes, especially due to Shigella and norovirus are often associated with seizure. Prompt identification and appropriate management of children with shigellosis may reduce occurrence and adverse consequences of seizure linked with MSD.

Source: Tropical Medicine and International Health. 2020 May 19. doi: 10.1111/tmi.13445.