Pathogen‐specific risk of seizure in children with moderate‐to‐severe diarrhoea: Case control study with follow‐up

Objective To determine the pathogen‐specific risk of seizure in under‐five children hospitalised with moderate‐to‐severe diarrhoea (MSD) in rural settings. Method This was a prospective case–control study with follow‐up, conducted in a sentinel facility of Global Enteric Multicenter Study in Mirzapur, a rural community of Bangladesh between 2007 and 2010. Children aged 0–59 months who presented with MSD and seizure constituted the cases whereas those who did not have seizure comprised the controls. MSD was defined if the episodes were associated with dehydration or dysentery or required hospitalisation with diarrhoea or dysentery. All enrolled children were followed up at home within 50–90 days of enrolment. A total of 64 cases and 128 randomly selected controls formed the analysable dataset. Results The result of logistic regression analysis after adjusting for potential confounders revealed that shigellosis (Shigella species, OR = 5.34, 95% CI = 2.37–12.04) particularly S. flexneri (OR = 3.34, 95% CI = 1.48–7.57), S. flexneri 6 (OR = 23.24, 95% CI = 2.79–193.85), S. sonnei (OR = 6.90, 95% CI = 2.34–19.85); norovirus (OR = 6.77, 95% CI = 1.69–27.11), fever (OR = 16.75, 95% CI = 1.81–154.70) and loss of consciousness (OR = 35.25, 95% CI = 1.71–726.20) were the independent risk factors for seizure in MSD children. At enrolment, cases had lower WHZ (P = 0.006) compared to their peers, follow‐up anthropometrics showed significant improvement in WHZ (P