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Risk factors for diarrhea among children in an industrialized country

Ethelberg, Steen ; Olesen, Bente ; Neimann, Jacob ; Schiellerup, Peter ; Helms, Morten ; Jensen, Charlotte ; Böttiger, Blenda LU ; Olsen, Katharina E P ; Scheutz, Flemming and Gerner-Smidt, Peter , et al. (2006) In Epidemiology 17(1). p.24-30
Abstract

BACKGROUND: Risk factors for childhood diarrhea in industrialized countries are not well characterized, although diarrhea remains an important cause of morbidity.

METHODS: We conducted a case-control study of 422 cases and 866 controls over 22 months in Denmark. We selected cases among children under 5 years of age with diarrhea. Age-matched healthy controls were selected from the background population using a population register. Parents were interviewed about possible exposures and underlying conditions. In addition, stool samples from both cases and controls were analyzed for viruses, parasites, and bacteria. We analyzed risk factors for diarrhea in general and for diarrhea of a viral, bacterial, or "unknown" etiology using... (More)

BACKGROUND: Risk factors for childhood diarrhea in industrialized countries are not well characterized, although diarrhea remains an important cause of morbidity.

METHODS: We conducted a case-control study of 422 cases and 866 controls over 22 months in Denmark. We selected cases among children under 5 years of age with diarrhea. Age-matched healthy controls were selected from the background population using a population register. Parents were interviewed about possible exposures and underlying conditions. In addition, stool samples from both cases and controls were analyzed for viruses, parasites, and bacteria. We analyzed risk factors for diarrhea in general and for diarrhea of a viral, bacterial, or "unknown" etiology using logistic regression.

RESULTS: The following factors were independently associated with an increased risk of diarrhea: recent foreign travel, contact with symptomatic persons (particularly in daycare centers), hospitalization, contact with a dog with diarrhea, private daycare, consumption of products containing formula milk, unemployment and low educational status of parents, and prior diagnosis of several types of atopic diseases. In a pathogenic-specific analysis of diarrhea of bacterial (73 patients), viral (88), or "unknown" (222) etiology, the major risk factor for viral diarrhea was contact with symptomatic persons. For bacterial diarrhea, foreign travel and socioeconomic factors were the main risk factors.

CONCLUSIONS: Viral diarrhea appears to be transmitted predominantly from person to person, whereas bacterial diarrhea appears to be primarily foodborne. A substantial portion of the diarrheal episodes may be of noninfectious etiology. Limiting child-to-child transmission of disease in daycare centers may substantially reduce the disease burden.

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publishing date
type
Contribution to journal
publication status
published
keywords
Animals, Animals, Domestic, Case-Control Studies, Child Day Care Centers, Child, Preschool, Denmark/epidemiology, Diarrhea/epidemiology, Disease Transmission, Infectious, Food Microbiology, Humans, Risk Factors
in
Epidemiology
volume
17
issue
1
pages
24 - 30
publisher
Wolters Kluwer
external identifiers
  • scopus:33644876874
  • pmid:16357591
ISSN
1044-3983
DOI
10.1097/01.ede.0000187621.41373.0a
language
English
LU publication?
no
id
ff3c5f29-3e43-4310-8368-72672a24c3ad
date added to LUP
2019-05-02 14:25:59
date last changed
2024-09-18 18:01:21
@article{ff3c5f29-3e43-4310-8368-72672a24c3ad,
  abstract     = {{<p>BACKGROUND: Risk factors for childhood diarrhea in industrialized countries are not well characterized, although diarrhea remains an important cause of morbidity.</p><p>METHODS: We conducted a case-control study of 422 cases and 866 controls over 22 months in Denmark. We selected cases among children under 5 years of age with diarrhea. Age-matched healthy controls were selected from the background population using a population register. Parents were interviewed about possible exposures and underlying conditions. In addition, stool samples from both cases and controls were analyzed for viruses, parasites, and bacteria. We analyzed risk factors for diarrhea in general and for diarrhea of a viral, bacterial, or "unknown" etiology using logistic regression.</p><p>RESULTS: The following factors were independently associated with an increased risk of diarrhea: recent foreign travel, contact with symptomatic persons (particularly in daycare centers), hospitalization, contact with a dog with diarrhea, private daycare, consumption of products containing formula milk, unemployment and low educational status of parents, and prior diagnosis of several types of atopic diseases. In a pathogenic-specific analysis of diarrhea of bacterial (73 patients), viral (88), or "unknown" (222) etiology, the major risk factor for viral diarrhea was contact with symptomatic persons. For bacterial diarrhea, foreign travel and socioeconomic factors were the main risk factors.</p><p>CONCLUSIONS: Viral diarrhea appears to be transmitted predominantly from person to person, whereas bacterial diarrhea appears to be primarily foodborne. A substantial portion of the diarrheal episodes may be of noninfectious etiology. Limiting child-to-child transmission of disease in daycare centers may substantially reduce the disease burden.</p>}},
  author       = {{Ethelberg, Steen and Olesen, Bente and Neimann, Jacob and Schiellerup, Peter and Helms, Morten and Jensen, Charlotte and Böttiger, Blenda and Olsen, Katharina E P and Scheutz, Flemming and Gerner-Smidt, Peter and Mølbak, Kåre}},
  issn         = {{1044-3983}},
  keywords     = {{Animals; Animals, Domestic; Case-Control Studies; Child Day Care Centers; Child, Preschool; Denmark/epidemiology; Diarrhea/epidemiology; Disease Transmission, Infectious; Food Microbiology; Humans; Risk Factors}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{24--30}},
  publisher    = {{Wolters Kluwer}},
  series       = {{Epidemiology}},
  title        = {{Risk factors for diarrhea among children in an industrialized country}},
  url          = {{http://dx.doi.org/10.1097/01.ede.0000187621.41373.0a}},
  doi          = {{10.1097/01.ede.0000187621.41373.0a}},
  volume       = {{17}},
  year         = {{2006}},
}