Risk Factors Associated with Severe Dehydration in Children with Acute Diarrhea in Emergency Settings

Abstract

Background: Acute diarrhea is a leading cause of emergency care to children hospital globally and it still makes a significant contribution to the under-five morbidity and mortality. The most life-threatening complication is severe dehydration that has to be identified and treated immediately. Knowledge of clinical and socioeconomic predictors in the emergency situation plays a crucial role in selecting prevention initiatives.

Aim: To identify the prevalence and independent predictors of severe dehydration in children that report to emergency departments with acute diarrhea.

Methods: It was a hospital-based analytical cross-sectional study that was done in three tertiary emergency departments that were based in pediatric units with a 12 months period. Four hundred and twenty children aged between 1-59 months old diagnosed with acute diarrhea underwent enrolment in consecutive sampling. The level of dehydration was categorized by the WHO. The sociodemographic and nutrition, clinical, and home-management variables were obtained by interviewing caregivers and examining these factors by the doctor. The logistic regression analysis showed the multivariate predictors of severe dehydration with adjusted odds ratio (AOR), and 95% confidence interval (CI) being evaluated.

Aim: 128 children were found to have severe dehydration (30.5%). Independent predictors were lack of oral rehydration therapy (AOR = 3.82; 95% CI: 2.156788), later presentation >48 hours (AOR = 3.12; 95% CI: 1.885.16), stool frequency>8/day (AOR = 2.91; 95% CI: 1.704.98), moderate/severe malnutrition (AOR = 2.74; 95)

Conclusion: In emergency departments in almost a third of cases of children with acute diarrhea, severe dehydration was found. The clinical severity indicators as well as modifiable home-care practices both posed a significant risk. Rehydration therapy at an early stage, breastfeeding and timely treatment are significant measures to decrease emergency complications and avoid death.