A study published in The Journal of Pediatrics assessed predictors of diarrhea and dehydration and to investigate the role of diarrhea in mortality among children with complicated severe acute malnutrition.

This prospective cohort study recruited400 children with complicated severe acute malnutrition. Children were treated according to the World Health Organization (WHO) and national guidelines, and diarrhea and dehydration were assessed daily.

The findings showed that the median (IQR) age was 15 months (range 11.2-19.2 months), 58% were boys while 61% had caregiver-reported diarrhea at admission. During hospitalization, the median number of days with diarrhea was 5 (range 0-31), the median duration of hospitalization was 17 days (range 1-69 days); however, 39 (10%) died. Moreover, out of the 592 diarrhea episodes monitored, 237 were admission episodes and 355 were hospital acquired. During hospitalization, young age was associated with days with diarrhea, whereas young age and HIV infection were associated with dehydration. Days with diarrhea and dehydration predicted the duration of hospitalization as well as mortality. The odds of mortality increased by a factor of 1.4 per day of diarrhea and 3.5 per unit increase in dehydration score.

It was concluded that diarrhea is a strong predictor of mortality among children with complicated severe acute malnutrition. Therefore, improved management of diarrhea and prevention of hospital-acquired diarrhea may aid in decreasing mortality.

Source: The Journal of Pediatrics. 2019 Jul;210:26-33.e3. doi: 10.1016/j.jpeds.2019.03.014.