Methodological considerations in defining chronic diarrhoea using a distributional approach. 1990

B F Stanton, and J D Clemens, and S Ahmed
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.

Attempts to develop effective treatment and preventive strategies for chronic diarrhoea have been confounded by inconsistencies in defining the disorder. In the present paper, we illustrate some of the methodological considerations encountered in using a distributional approach to define chronic diarrhoea. We employ data obtained from 3470 children aged less than six years residing in Dhaka, Bangladesh, between January 1985 and January 1986. The importance of defining the age of the target population is demonstrated by the inverse correlation between age and duration of episodes required to reach or exceed the 95th percentile, ranging from 27 days in children aged less than 12 months to 18 days in children aged over four years. Altering the percentile cut-off qualifying as 'chronic' from the 95th percentile to the 90th percentile changed the minimum qualifying duration from 24 to 16 days. We also demonstrate the impact of altering criteria for termination of an episode and of altering the duration of the monitoring period on the resultant length of episodes classified as 'chronic'.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003967 Diarrhea An increased liquidity or decreased consistency of FECES, such as running stool. Fecal consistency is related to the ratio of water-holding capacity of insoluble solids to total water, rather than the amount of water present. Diarrhea is not hyperdefecation or increased fecal weight. Diarrheas
D004812 Epidemiologic Methods Research techniques that focus on study designs and data gathering methods in human and animal populations. Epidemiologic Method,Epidemiological Methods,Methods, Epidemiologic,Epidemiological Method,Method, Epidemiologic,Method, Epidemiological,Methods, Epidemiological
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001459 Bangladesh A country in Southern Asia, bordering the Bay of Bengal, between Burma and India. The capital is Dhaka.

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