Management of persistent diarrhea

ABSTRACT

PD was defined by the World Health Organization [WHO] as "diarrheal episodes of presumed infectious etiology that begin acutely, but have an unusually long duration lasting at least 14 days leading to a deterioration in nutritional status and a substantial risk of death. The establishment of a 14-day cutoff value to distinguish acute from persistent diarrhea was justified by the fact that mortality rates were found to be roughly 0.8% when the diarrheal episode lasted 14 days or fewer, only to climb to 14% when duration of the episode exceeded 14 days, which led to the characterization of PD as a potentially lethal condition. The factors associated with increased risk of PD are environment-related, such as poor hygiene, contact with animals, and fecal-oral spread of enteric pathogens. Furthermore, there are other host-related*indicators, including young age, lack of breast feeding, immune deficiency, a prior history of gastrointestinal and respiratory infection