Utilidad del estudio de las heces para el diagnóstico y manejo de lactantes y prescolares con diarrea aguda / Utility of studying feces for the diagnosis and management of infants and preschool children with acute diarrhea
Salud pública Méx
;
44(4): 328-334, jul.-aug. 2002.
Article
in Spanish
| LILACS
| ID: lil-331708
RESUMO
OBJECTIVE:
To analyze the results of a stool work-up protocol in a series of infants and preschoolers with acute diarrhea. MATERIAL ANDMETHODS:
A cross-sectional descriptive study was conducted between April 1999 and March 2000, among 288 children seen at a pediatric office in Guadalajara, Mexico. The mean age (+/-/SD) was 23.1 +/- 13.9 months; 43 were females. Data were collected on demographic and clinical characteristics. The stool work-up consisted of fresh smear and methylene blue and Kinyoun smears, as well as determination of pH and reducing substances. Stool culture was performed in samples with > or = 3 leukocytes/microscopic field and rotavirus antigen detection only in selected cases. Data were analyzed using descriptive statistics, chi 2, odds ratios, and 95 confidence intervals.RESULTS:
Enterophatogens () identified were rotavirus 47.1, Campylobacter jejuni 27.4, Salmonella spp. 5.1, Shigella spp. 4.3, Cryptosporidium parvum 2.8, Giardia lamblia 2.4, Blastocystis hominis 1.4, Entamoeba histolytica 0.7. An OR of 5.7 was obtained for isolation of enteroinvasive bacteria in the presence of fecal leukocytes. Lactose intolerance was detected in 19.1. The frequencies of rotavirus antigen identification and lactose intolerance were significantly higher in infants; the OR for lactose intolerance in infants with rotavirus was 21. Mucus and blood in the stools were associated to enteroinvasive bacteria and Cryptosporidium parvum.CONCLUSIONS:
The current stool work-up protocol allowed the identification of enteropathogenic parasites, rotavirus and lactose intolerance in a short period of time. Leukocytes in stools were associated to the isolation of enteroinvasive bacteria. The frequency of agents associated to diarrheal disease was similar to that from other national studies. This stool work-up protocol could be useful as a tool to limit the unnecessary prescription of drugs and to follow universal recommendations for dietary management of these patients.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Diarrhea
/
Feces
Type of study:
Diagnostic study
/
Etiology study
/
Practice guideline
/
Incidence study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Animals
/
Female
/
Humans
/
Male
Country/Region as subject:
Mexico
Language:
Spanish
Journal:
Salud pública Méx
Journal subject:
Public Health
Year:
2002
Type:
Article
Affiliation country:
Mexico
Institution/Affiliation country:
Instituto Mexicano del Seguro Social/MX
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