Hospital Acquired Diarrhoea in Children: A Study in a Tertiary Care Hospital in Sylhet

Tahmina Jahan Chowdhury, Naznin Akther, Jannatul Ferdush Chowdhury, Shaila Begum, Zainab Rahman, Tofayel Ahmed
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Abstract

Background: Children hospitalized for diseases other than diarrhoea can be infected with an enteric pathogen during their stay at hospital, which may complicate and prolongs the course of illness and hospital stay. Hospital acquired diarrhoea are defined as those occurring more than 72 hours after admission to hospital. Nosocomial diarrhoea second to nosocomial respiratory tract infections in causing morbidity among hospitalized children. Objectives: The study was designed to find the rate of hospital acquired diarrhoea, their risk factors and to observe the clinical features. Method: This cross-sectional observational study was conducted in the inpatient department of Pediatrics in Jalalabad Ragib-Rabeya Medical College, Sylhet over a period of 3 months between July to September 2018. A total number of 274 children aged from 1 month to 5 years were admitted in inpatient department other than diarrhoea were included in the study. During their hospital stay, all patients were followed up daily for development of diarrhoea. Results: Out of 274 children 80 patients developeddiarrhoea 72 hours after admission, the rate of occurrence of hospital acquired diarrhoea was 29.2%. Patients who developed hospital acquired diarrhoea, were initially admitted due to pneumonia accounted for about 65% followed by 12.5% due to malnutrition. Patients aged below two years and staying in hospital for longer duration developed diarrhoea more. Presence of any diarrhoeal patient in a bed close the patient’s bed (p=0.00001), hand washing by mother’s during handling baby (p=0.00001), hand washing by doctors (p=0.00001), and sharing the bathroom with diarrhoeal patient (p=0.000061), were statistically associated with the development of nosocomial diarrhoea. Diarrhoea was mostly watery in nature (80%) having pus (80%) and RBC (100%) on stool microscopy and patients suffered from milder dehydration (80%). Conclusions: Hospital acquired diarrhoea is common in admitted patients, which may complicate the disease course, prolonged the hospital stay. J Rang Med Col. March 2024; Vol. 9, No. 1: 65-70
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医院获得性儿童腹泻:锡尔赫特一家三级医院的研究
背景:因腹泻以外的疾病住院的儿童可能会在住院期间感染肠道病原体,这可能会使病情复杂化并延长住院时间。医院感染性腹泻是指入院后 72 小时以上发生的腹泻。在导致住院儿童发病率方面,院内腹泻仅次于院内呼吸道感染。研究目的本研究旨在了解医院感染性腹泻的发病率、风险因素并观察其临床特征。研究方法这项横断面观察性研究于 2018 年 7 月至 9 月在锡尔赫特贾拉拉巴德拉吉卜-拉贝亚医学院儿科住院部进行,为期 3 个月。共有 274 名年龄在 1 个月至 5 岁之间的儿童被纳入研究,他们均在住院部接受了腹泻以外的治疗。在住院期间,每天对所有患者的腹泻情况进行随访。研究结果在 274 名儿童中,有 80 名儿童在入院 72 小时后出现腹泻,医院获得性腹泻的发生率为 29.2%。最初因肺炎入院的患者约占 65%,其次是因营养不良入院的患者,占 12.5%。两岁以下和住院时间较长的患者患腹泻的比例较高。与腹泻病人同床(P=0.00001)、母亲在处理婴儿时洗手(P=0.00001)、医生洗手(P=0.00001)和与腹泻病人共用浴室(P=0.000061)与发生院内腹泻有统计学关联。腹泻多为水样(80%),粪便显微镜检查有脓液(80%)和红细胞(100%),患者脱水程度较轻(80%)。结论医院感染性腹泻在住院病人中很常见,可能会使病程复杂化,延长住院时间。
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