Children with both severe wasting and severe stunting (SWSS) represent an extreme form of malnutrition and are prone to develop severe infection.

The goal of a new study published in Tropical Medicine and International Health was to demonstrate clinical features and etiology of diarrhea among children with SWSS compared to those with either severe wasting (SW) or severe stunting (SS), which may help in early identification of high-risk children.

Here, information was extracted from the database of the diarrheal disease surveillance system (DDSS) of Dhaka Hospital, from 2008-2017.

It was found that among 14 403 under-five diarrheal children, 149 had concurrent SWSS; 795 had SW alone; and 1000 had only SS. In logistic regression analysis after adjusting for potential confounders, dehydrating diarrhea and slum dwelling were independently associated with SWSS vs. SW. In addition, when compared to SS, dehydration and maternal illiteracy was independently associated with SWSS. On the other hand, relative to SW or SS, infection with rotavirus was less frequent in SWSS. Moreover, dehydration was independently associated with SW versus SS after adjusting for potential confounders.

The findings suggested that children with SWSS more often presented with dehydrating diarrhea than children who had either SW or SS. Whereas, SWSS patients less frequently presented with rotavirus-associated diarrheal illnesses. Hence, the results highlighted the importance of early detection and prompt management of dehydrating diarrhea in children with concomitant SWSS, to reduce morbidity and mortality in children, especially in poor settings.

Source: Tropical Medicine and International Health. 2020 May 23. doi: 10.1111/tmi.13446.