Abstract
The cause of death (besides dehydration) for 140 diarrhoeal patients who died in hospital following rehydration was determined by autopsy examination. Children under 5 years comprised 74% of the patients. Diarrhoeal pathogens were identified as Shigella spp. in 27%, enterotoxigenic Escherichia coli in 17%, Entamoeba histolytica in 16%, Campylobacter jejuni in 12%, Salmonella spp. in 4%, Vibrio cholerae in 4%, and Giardia lambliain 4% of cases. The most frequent underlying causes of death were colitis in 44% and pneumonia in 38%. The most frequent immediate causes of death were septicaemia in 27%, hypoglycaemia in 9%, and hypokalaemia in 9%; multiple causes of death were present in 89% of cases. Kwashiorkor or marasmus was present in 59% and fatty degeneration of the liver was detected in 61% of cases. It is concluded that, in susceptible children, diarrhoeal pathogens produce destructive inflammation in the intestine and cause death or contribute to it by provoking disease in other tissues, especially septicaemia and fatty liver, or by combining these effects with antecedent or concomitant conditions, especially pneumonia and malnutrition.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barrett-Connor E., Connor J. D. Extraintestinal manifestations of shigellosis. Am J Gastroenterol. 1970 Mar;53(3):234–245. [PubMed] [Google Scholar]
- Carter J. R. The problematic death certificate. N Engl J Med. 1985 Nov 14;313(20):1285–1286. doi: 10.1056/NEJM198511143132009. [DOI] [PubMed] [Google Scholar]
- Chamblee R. F., Evans M. C. New dimensions in cause of death statistics. Am J Public Health. 1982 Nov;72(11):1265–1270. doi: 10.2105/ajph.72.11.1265. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chen L. C., Rahman M., Sarder A. M. Epidemiology and causes of death among children in a rural area of Bangladesh. Int J Epidemiol. 1980 Mar;9(1):25–33. doi: 10.1093/ije/9.1.25. [DOI] [PubMed] [Google Scholar]
- Hirschhorn N., Lindenbaum J., Greenough W. B., 3rd, Alam S. M. Hypoglycemia in children with acute diarrhoea. Lancet. 1966 Jul 16;2(7455):128–132. doi: 10.1016/s0140-6736(66)92421-4. [DOI] [PubMed] [Google Scholar]
- Monto A. S., Koopman J. S. The Tecumseh Study. XI. Occurrence of acute enteric illness in the community. Am J Epidemiol. 1980 Sep;112(3):323–333. doi: 10.1093/oxfordjournals.aje.a112998. [DOI] [PubMed] [Google Scholar]
- Nalin D. R. Mortality from cholera and other diarrhoeal diseases at a cholera hospital. Trop Geogr Med. 1972 Jun;24(2):101–106. [PubMed] [Google Scholar]
- Snyder J. D., Merson M. H. The magnitude of the global problem of acute diarrhoeal disease: a review of active surveillance data. Bull World Health Organ. 1982;60(4):605–613. [PMC free article] [PubMed] [Google Scholar]
- Yoshino M. Effect of Shigella flexneri endotoxin on ureagenesis and liver ultrastructure in rabbits. Exp Mol Pathol. 1980 Jun;32(3):253–263. doi: 10.1016/0014-4800(80)90059-3. [DOI] [PubMed] [Google Scholar]