Risk Factors and Gender Differentials for Death among Children Hospitalized with Diarrhoea in Bangladesh

Abstract

To identify risk factors for death among children with diarrhoea, a cohort of 496 children, aged less than 5 years, admitted to the intensive care unit of a diarrhoeal disease hospital in Bangladesh, was studied during November 1992-June 1994. Clinical and laboratory records of children who died and of those who recovered in the hospital were compared. Deaths were significantly higher among those who had altered consciousness, hypoglycaemia, septicaemia, paralytic ileus, toxic colitis, necrotizing enterocolitis, haemolytic-uraemic syndrome, invasive or persistent diarrhoea, dehydration, electrolyte imbalances, and malnutrition. Females experienced a 2-fold higher risk of death than males (p=0.003). Several indices of severe infections were identified more frequently among females than males. Females with severe infections were less frequently brought to the hospital than their male counterparts. The time lapse between onset of symptoms and hospital admission was significantly higher in females than males. This study suggests initiation of programmes to alleviate social disparity between genders for healthcare in poor communities. The study-results may also help physicians identify either prognostic indicators or risk factors for death among children hospitalized with severe illnesses associated with diarrhoea.