Diarrhea-associated micronutrient deficiencies and risk of subsequent diarrhea in admitted children to Hajar hospital in Shahrekord, Iran

Background: Acute infectious diarrhea is still one of the most important causes of death in childhood and malnutrition increases its morbidity and mortality. There is a strong correlation between the nutritional status of the child and the risk of subsequent diarrhea. Micronutrient deficiencies also increase the child’s susceptibility to diarrhea and vitamin A and zinc supplementation has been shown to reduce the incidence and hasten recovery from acute diarrhea episodes. Materials and methods: This study describes the association of nutritional deficiencies and other factors on the risk of subsequent diarrhea in children in Shahrekord, Iran. A cohort of 211 children less than 5 years old admitted with acute diarrhea to Hajar Hospital in Shahrekord, were followed for 14 weeks after hospital discharge. Results: Fifty-eight (27%) of these children developed a new diarrhea episode during the follow up period. Children who were vitamin A and zinc deficient at the time of admission, above 12 months of age, kept animals at home or had weight-for-age and weight-for-height z scores < -1 during the univariate analysis had a higher risk of experiencing subsequent diarrhea. Vitamin A and zinc deficiencies, keeping animals at home, diarrhea duration ? 4 days on enrolment and weight-for-age z score < -1 reminded as independent risk factors during multivariate analysis. The aggregation of these factors had a synergistic effect on the risk of subsequent diarrhea. Conclusion: Children with micronutrient deficiencies and in contact with animal had the highest risk of suffering subsequent diarrhea. Our findings support the current approach of providing multiple micronutrient supplements for the prevention of infection in order to reduce mortality in children.