Urban-Rural Differentials in Overweight and Obese Individuals with Diarrhea in Bangladesh

作者：Das Sumon Kumar; Chisti Mohammod Jobayer; Malek Mohammad Abdul; Vanderlee Lana; Salam Mohammed Abdus; Ahmed Tahmeed; Bardhan Pradip Kumar; Faruque Abu Syed Golam^*; Al Mamun Abdullah

来源：Journal of the American College of Nutrition, 2014, 33(6): 459-465.

DOI：10.1080/07315724.2013.875412

• urban
• rural
• Bangladesh
• overweight
• obesity
• diarrhea

Objective: The study aimed to determine urban and rural differences in overweight and obesity (OO) with diarrhea regarding subjects%26apos; sociodemographic, clinical characteristics, etiology, and antimicrobial susceptibility. %26lt;br%26gt;Methods: Relevant information from 2000 to 2011 were extracted from the data archive of the Diarrheal Disease Surveillance System of urban Dhaka (1248, 4.5%) and rural Matlab (615, 3.4%) hospitals of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b). %26lt;br%26gt;Results: The proportion of OO significantly increased in both urban (3-7%; chi-square for trend p %26lt; 0.001) and rural (1-6%; p %26lt; 0.001) areas over the study period. In multivariate modeling, monthly income more than US$100 (odds ratio [OR] = 54.44, 95% confidence interval [CI], 25.37-116.82, p %26lt; 0.001), high wealth quintile (OR = 18.23, 95% CI, 8.63-38.49, p %26lt; 0.001), access to sanitary toilet (OR = 3.07. 95% CI. 1.76-5.26. p %26lt; 0.001), boiled drinking water (OR = 2.77, 95% CI, 1.09-7.05, p = 0.032), antimicrobial use before hospitalization (OR = 4.99, 95% CI, 2.85-8.74, p %26lt; 0.001), fever (OR = 0.14, 95% CI, 0.37, 0.50, p %26lt; 0.001), watery stools (OR = 5.59, 95% CI, 2.11-14.80, p %26lt; 0.001), dehydrating diarrhea (OR = 5.17, 95% CI, 2.54-10.52, p %26lt; 0.001), intravenous saline infusion after hospitalization (OR = 2.65, 95% CI, 1.28-5.49, p = 0.009), and Salmonella infection (OR = 0.20, 95% CI, 0.50-0.83, p = 0.027) remained significantly associated with urban OO individuals. At least 88% of Shigella isolates were susceptible to ciprofloxacin in both urban and rural areas; for mecillinum it was 90%. Ciprofloxacin had the least detected resistance for Vibrio cholerae (0%) and trimethoprim-sulfamethoxazole (TMP-SMX) showed the greatest resistance (Dhaka 86%; Matlab 98%). Susceptibility for Salmonella showed ampicillin (95%), chloramphenecol (100%), ciprofloxacin (95%), ceftraxone (93%), TMP-SMX (95%) at both sites. %26lt;br%26gt;Conclusion: Urban OO with diarrheal illnesses was significantly different from that in rural areas, including antimicrobial susceptibility.

• 出版日期2014-11-2