Diarrhea and its effect on growth

Abstract

The predominant etiology of diarrhea in the general population of underdeveloped countries is infection by viruses and bacteria. Studies in rural areas clearly suggest an infectious cause. For example, diarrhea initially affects one individual in the family (index case) and then spreads to other family and community members. Infants and toddlers are affected more frequently than older children, adolescents, and adults. The 4,40/ high prevalence of diarrhea in populations with poor personal hygiene and deficient environmental sanitation also points to an infectious cause and is supported by the identification of rotaviruses, Campylobacter, enterotoxigenic enteric bacteria, Cryptosporidium, Shigella, Vibrio cholerae, Salmonella, Giardia, and other parasites in most patients with diarrhea. Longitudinal studies of children in deprived ecosystems have documented the significance of diarrheal disease in respect to poor nutrition and growth. 1-3 These studies reveal not only the frequency of diarrhea in infants and young children but also the severity of damage from infectious diseases of the GI tract and their resultant inhibition of good nutrition and normal growth. Many children in Guatemala, Bangladesh, and northeastern Brazil experience from six to nine episodes of diarrhea per year during their first three years of life. 1-3 Most episodes last for a few days and resolve without serious consequences. Other incidents result in considerable losses of fluids and electrolytes or are accompanied by fever, anorexia, and considerable damage to the intestinal mucosa. The worst episodes yield sequelae and permanent damage, such as growth retardation, or result in death.