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American Journal of Epidemiology Vol. 135, No. 5: 541-551
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Diarrheal Disease in Cambodian Children at a Camp in Thailand

James D. Arthur1,, Ladaporn Bodhidatta1, Peter Echeverria1, Surasith Phuphaisan2 and Sakti Paul3

1Department of Bacteriology, Armed Forces Research Institute of Medical Sciences (AFRMS) Bangkok, Thailand
2Catholic Relief Services Surin, Thailand
3United Nations Border Relief Operation Arany-aprathet, Thailand

Reprint requests to Dr. Peter Echeverria, Dept. of Bacteriology, AFRIMS, 315/6 Rajvithi Road, Bangkok 10400, Thailand. From the United States, write to Dr. Echeverria at the Dept. of Bacteriology, AFRIMS, APO AP 96546

The etiology of acute diarrhea (≤3 days duration) and persistent diarrhea (≥14 days duration) was determined in Cambodian children under age 5 years in a refugee camp on the Thai-Cambodian border between May and October 1989; potential risk factors associated with persistent diarrhea were examined in an age-matched case-control study. Specimens collected from children and environmental sources were examined by standard microbiologic methods; Escherichia coli isolates were examined for hybridization with specific DNA probes and in tissue culture adherence assays. The same bacterial, viral, or parasitic agents were identified in 79 children with persistent diarrhea and in 408 children with acute diarrhea. Only one of nine children with persistent diarrhea excreted the same organism, Cryptosporidium, for that extended period. The most important risk factors identified for developing persistent diarrhea were living with other young children (odds ratio (OR) = 2.0, 95% confidence interval (Cl) 1.2–3.4) and being undernourished (OR = 2.6, 95% Cl 1.2–5.7). Persistent diarrhea in children in this camp was associated with several different agents rather than persistent infections with a single organism.

Campylobacter; Cryptosporidium; diarrhea; Escherichia coli; refugees; rotaviruses; Shigella


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