Sex and Gender Differences in Acute Pediatric Diarrhea: A Secondary Analysis of the DHAKA Study

Pediatric diarrheal disease is a significant source of morbidity and mortality in the developing world. While several studies have demonstrated an increased incidence of diarrheal illness in boys compared with girls in low- and middle-income countries (LMIC), the reasons for this difference are uncl...

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Published inJournal of epidemiology and global health Vol. 8; no. 1-2; pp. 42 - 47
Main Authors Jarman, Angela F., Long, Sara E., Robertson, Sarah E., Nasrin, Sabiha, Alam, Nur Haque, McGregor, Alyson J., Levine, Adam C.
Format Journal Article
LanguageEnglish
Published Dordrecht Springer Netherlands 01.12.2018
Springer Nature B.V
Atlantis Press
Springer
Subjects
Age
Bangladesh
Children
Children & youth
Dehydration
Diarrhea
diarrheal illness
gender
Girls
Malnutrition
Morbidity
Nutritional status
Original
Original Article
pediatric
Pediatrics
Rehydration
Sex differences
Bangladesh
gender
diarrheal illness
pediatric
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Summary:Pediatric diarrheal disease is a significant source of morbidity and mortality in the developing world. While several studies have demonstrated an increased incidence of diarrheal illness in boys compared with girls in low- and middle-income countries (LMIC), the reasons for this difference are unclear. This secondary analysis of the dehydration: assessing kids accurately (DHAKA) derivation and validation studies included children aged <5 years old with acute diarrhea in Dhaka, Bangladesh. The dehydration status was established by percentage weight change with rehydration. Multivariable regression was used to compare percent dehydration, while controlling for differences in age and nutritional status. In this cohort, a total of 1396 children were analyzed; 785 were male (56.2%) and 611 were female (43.8%). Girls presenting with diarrhea were older than boys (median age 17 months vs. 15 months, p = 0.02) and had significantly more malnutrition than boys, even when controlled for age (mean mid-upper arm circumference 134.2 mm vs. 136.4 mm, p < 0.01). The mean percent dehydration did not differ between boys and girls after controlling for age and nutrition status ( p = 0.25). Although girls did have higher rates of malnutrition than boys, measures of diarrhea severity were similar between the two groups, arguing against a cultural bias in care-seeking behavior that favors boys.
ISSN:2210-6006
2210-6014
2210-6006
DOI:10.2991/j.jegh.2018.08.102