Risk Factors Analysis of Gastro- Intestinal Infections among the Patients in Tertiary Care Hospital in Dhaka, Bangladesh

Background: Viral hepatitis is one of the major public healthconcerns around the world. Every year millions of people diefrom viral hepatitis-related cirrhosis and liver cancer. Howeverthe fact is the majority of the infected populations are unawareof their condition.Objective: The objective of the study was to find out theproportion of the risk factors associated with gastrointestinalinfections among the inpatients attending in tertiary carehospital in Dhaka city.Materials & Methods: A cross-sectional study was carried outamong the hospital admitted patients at gastroenterologydepartment from January to April, 2019.A total of 193patientswere purposively selected who were above 18 years anddiagnosed case of hepatitis, diarrhoeal diseases, enteric fever,H. pylori infection.Results: The outcome of the study was that, majority82(42.5%) of the patients age was between 21-40 years.Maximum participants were male (65.3%). Study found thatamong 193 patients, 45 (23.3%) were diagnosed as hepatitisB, 31 (16.1%) were H. pylori infection, 29 (15.0%) diarrhoea,hepatitis C 19 (9.8%), hepatitis E 23 (11.9%) and hepatitis A 21(10.9%). It also found that mean duration of Gastro-Intestinal(GI) infection was 2.59 (± 3.22) years. Water borne diseaseslike hepatitis A, E, diarrhoea, typhoid and H. pylori infectionmostly presents due to 44 (34.4%) patients drunk water fromsupply water (Dhaka WASA), 73.4% eaten street juice and79.7% had eaten street food before diagnosed diseases.Commonest risk factors were hepatitis B and C. 37 (56.9%)patients had received blood previously, 11 (17.2%) had theirprevious history of operation, 42 (64.6%) had visited dentist fordental issues, 29 (44.6%) patients attended endoscopy orcolonoscopy test, 28 (43.1%) patients informed that they hadfaced minor skin injury when shaving in salon and 6 (9.2%)patients mentioned taken dialysis. According to the findings,20.3% patients having liver diseases, 5.7% heart diseases,4.1% respiratory diseases, 7.3% renal diseases, 26.4%diabetic, 22.8% hypertensive, 15.0% anemia and 26.9%smoker Street juice [OR: 95% CI, 4.9%] and Street food [OR:95% CI, 6.1%] risk of hepatitis A infection. The proportion ofrisk factors of hepatitis B infection revealed that the patientswho received blood previously [OR: 95% CI, 3.14%] has therisk of hepatitis, second hand razor use [OR: 95% CI, 7.76%],Dialysis [OR: 95% CI, 2.47%].Conclusion: Street foods & juice, unpurified water was thecommonest factors of hepatitis A &E, typhoid and diarrhea. Onthe other side, unscreened blood, dental procedure, skin injuryin saloon, dialysis and endoscopy/colonoscopy test were thecommonest risk of hepatitis B& C virus. H. pylori infection

Socio-demographic determinants of diarrhoeal diseases among under five years old children in Rwanda

Background Diarrhoeal disease is a worldwide public health issue and remains a major cause of mortality and morbidity in children under five years old. Low and middle income countries (LMIC) of Africa and part of Asia are more affected by diarrhoeal diseases. Objectives To measure the prevalence of Diarrhoeal Diseases and to assess Socio-demographic determinants among Under Five Years Old Children in Rwanda. Methods A cross-sectional design was used. Secondary data analysis was carried out on a sample of 7474 drawn from Rwanda Demographic and Health Survey (RDHS). RDHS used multistage sampling technique. Results After running multiple logistic regression, Sociodemographic determinants associated with diarrhoeal included age of children, wealth index category, mother education, husband/partner education, types of place of residence (P-Value) Conclusion The results of the study showed that diarrhoeal remains an important health issue in Rwanda. Occurrence of diarrhoeal was statistically associated with child age, wealth index, education of parents, types of place of residence.

Study of diarrheal disease among under five children in a rural community: telephone based follow up study

Background: Acute diarrhoeal diseases are one of the leading causes of morbidity and mortality in the developing countries and a major contribution of malnutrition especially among infants and children under 5 years of age. Approximately two-thirds of the world population live in the developing countries characterized by a lack of potable drinking water, improper means of disposal of human faecal waste, intense crowding in houses and often primitive standards of personal hygiene. In India, diarrhoeal diseases are a major public health problem among children under 5 years. The objective of the study was to estimate number of episodes of diarrhoea in children under five years in a rural area.Methods: Community based longitudinal study conducted among 622 children.Results: The overall incidence of diarrhoeal disease was found to be 2.11 episode/child/year. It was observed that the diarrhoeal disease morbidity decreased with the increasing age of the child. Diarrhoeal disease morbidity increased in children from lower socioeconomic status 2.32 episodes/child/year.Conclusions: The lower incidence rate has been found in those children who were better nourished, had received immunization and had been breast fed. Hence there is a need to make efforts to still further improve and sustain immunization coverage, give importance to the nutrition of the children, encourage the mothers to breast feed their children for at least 2 years.

Healthcare-use for Major Infectious Disease Syndromes in an Informal Settlement in Nairobi, Kenya.

A healthcare-use survey was conducted in the Kibera informal settlement in Nairobi, Kenya, in July 2005 to inform subsequent surveillance in the site for infectious diseases. Sets of standardized questionnaires were administered to 1,542 caretakers and heads of households with one or more child(ren) aged less than five years. The average household-size was 5.1 (range 1-15) persons. Most (90%) resided in a single room with monthly rents of US$ 4.50-7.00. Within the previous two weeks, 49% of children (n=1,378) aged less than five years (under-five children) and 18% of persons (n=1,139) aged ≥5 years experienced febrile, diarrhoeal or respiratory illnesses. The large majority (>75%) of illnesses were associated with healthcareseeking. While licensed clinics were the most-frequently visited settings, kiosks, unlicensed care providers, and traditional healers were also frequently visited. Expense was cited most often (50%) as the reason for not seeking healthcare. Of those who sought healthcare, 34-44% of the first and/or the only visits were made with non-licensed care providers, potentially delaying opportunities for early optimal intervention. The proportions of patients accessing healthcare facilities were higher with diarrhoeal disease and fever (but not for respiratory diseases in under-five children) than those reported from a contemporaneous study conducted in a rural area in Kenya. The findings support community-based rather than facility-based surveillance in this setting to achieve objectives for comprehensive assessment of the burden of disease.

Directing Diarrhoeal Disease Research towards Disease-burden Reduction.

Despite gains in controlling mortality relating to diarrhoeal disease, the burden of disease remains unacceptably high. To refocus health research to target disease-burden reduction as the goal of research in child health, the Child Health and Nutrition Research Initiative developed a systematic strategy to rank health research options. This priority-setting exercise included listing of 46 competitive research options in diarrhoeal disease and their critical and quantitative appraisal by 10 experts based on five criteria for research that reflect the ability of the research to be translated into interventions and achieved disease-burden reduction. These criteria included the answerability of the research questions; the efficacy and effectiveness of the intervention resulting from the research; the maximal potential for disease-burden reduction of the interventions derived from the research; the affordability, deliverability, and sustainability of the intervention supported by the research; and the overall effect of the research-derived intervention on equity. Experts scored each research option independently to delineate the best investments for diarrhoeal disease control in the developing world to reduce the burden of disease by 2015. Priority scores obtained for health policy and systems research obtained eight of the top 10 rankings in overall scores, indicating that current investments in health research are significantly different from those estimated to be the most effective in reducing the global burden of diarrhoeal disease by 2015.

The relationship between the family income, maternal education, maternal age, birth order, the weight of infant and the episodes of diarrhoeal diseases in the first six months of life.

Influential factors in the diarrhoeal diseases are pathological agents, host and environment. Lower socioeconomic environment is the predisposing factor to the diarrhoeal diseases. This paper is to report the family income, maternal education, maternal age, birth order, the weight of infant and the relationship of each of these factors to the episodes of diarrhoeal diseases in the first six months of life. The infants were divided into 4 groups :- 1st group had no diarrhoeal, 2nd , 3rd and 4th groups had diarrhea with one, two to three and over three episodes respectively. There were no statistically significant difference noted between the groups of diarrhoeal episodes and the family income, maternal education, the weight of infants and birth order. The diarrhoeal diseases occurred more knowledge about proper care of her infant which contributed to the increased episodes of diarrhoeal disease.