Changing trend of persistent diarrhoea in young children over two decades: observations from a large diarrhoeal disease hospital in Bangladesh


Abu Syed Golam Faruque, Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh. Tel: +880-2-9860704 | Fax: +880-2-9860704 | Email:


Aim:  We studied the changing trend and factors associated with persistent diarrhoea (PD) in under-five children presenting to a large diarrhoeal disease hospital in urban Dhaka, Bangladesh, over the last two decades.

Methods:  We used an unmatched case–control design, with a case (persistent diarrhoea; n = 944) to control (acute diarrhoea; n = 2832) ratio of 1:3 attending the Dhaka Hospital of icddr,b between 1991 and 2010.

Results:  The proportion of children with PD decreased significantly from 8% in 1991 to 1% in 2010. The proportion of breastfeeding practices, measles vaccination coverage and vitamin A supplementation among 12–59 months old improved from 79% to 85%, 69% to 85% and 26% to 74%, respectively, which were significant. Although the isolation of rotavirus from stool in children with PD and acute diarrhoea increased, the isolation of Shigella spp., and Vibrio cholerae O1 decreased significantly. In a logistic regression analysis, wasting (OR = 1.62), use of antibiotic before attending hospital (OR = 5.94), absent clinical dehydration (OR = 1.53) and bloody/mucoid stool (OR = 3.33) were significantly associated with persistent diarrhoea.

Conclusion:  There, thus, is a need to integrate an appropriate and sustainable deterrent strategy to take the benefit of the significant reduction in prevalence as well as risks of PD in such population.