Original ArticlesEffects of nutritional status on diarrhea in Peruvian children☆,☆☆
Section snippets
Material and methods
The study was conducted in Pampas de San Juan, a peri-urban community of approximately 40,000 residents. The majority of residents are immigrant families from rural areas of the Peruvian Andes. This community was established late in 1970 and was highly transitional for more than a decade. Today, it has low emigration. Pampas de San Juan is built around a cluster of sand hills located 25 km south of metropolitan Lima. The early settlers live downhill in the more established households, which are
Results
The 230 children were followed longitudinally for 159,551 child-days. During the study period we identified 1387 episodes of diarrhea, yielding a point prevalence of 2.1% and an incidence of 3.2 diarrheal episodes per child-year.
Discussion
Nutritional status was a significant predictor of diarrheal incidence in a study population with high levels of stunting but low levels of wasting. The frequency of diarrhea increased by 15% per SD decrease in the height-for-age z score after controlling for age and other variables. The association between diarrheal incidence and height-for-age remained significant even after controlling for age and environmental variables such as water supply and sanitation facilities. On the other hand,
Acknowledgements
The authors extend special thanks to Drs C. Bern and M. D. Chestnut for helpful comments and Ms J. B. Phu and Ms D. Sara for technical assistance.
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Supported by a National Research Service Award of the National Institutes of Child Health and Development (F31-HD08488) (to W. C.), an ICTDR grant of the National Institutes of Allergy and Infectious Diseases awarded to The Johns Hopkins School of Public Health (U01-A135894), an ITREID training grant awarded to the Johns Hopkins University, and the charitable RG-ER foundation for the advancement of diarrheal disease research.
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Reprint requests: William Checkley, The Johns Hopkins University, Bloomberg School of Public Health, Department of International Health, 615 N Wolfe St, W3503, Baltimore, MD 21205.