Acute gastroenteritis (AGE) is one of the most common illnesses affecting children under five years of age worldwide. It is characterized by diarrhea with or without vomiting, often leading to dehydration. Despite advances in healthcare, AGE continues to be a major public health problem in developing countries.

Globally, diarrhea accounts for a substantial proportion of childhood deaths. Factors such as poor sanitation, unsafe drinking water, malnutrition, and inappropriate feeding practices contribute significantly to disease burden.

Understanding the clinical profile and associated risk factors is essential for early diagnosis, appropriate management, and prevention strategies. This study aims to evaluate the clinical presentation and identify risk factors associated with AGE in under-five children.

Study Design and Setting A hospital-based cross-sectional study conducted in the Department of Pediatrics of a tertiary care hospital. Study Duration 12 months. Study Population Children aged 6 months to 5 years presenting with acute gastroenteritis. Sample Size 200 children. Inclusion Criteria • Children aged 6 months to 5 years • Presenting with diarrhea (≥3 loose stools/day) Exclusion Criteria • Chronic diarrhea • Severe systemic illness • Known gastrointestinal disorders Data Collection Data were collected using a structured proforma: • Demographic details • Clinical features • Feeding practices • Immunization status • Sanitation and hygiene practices Assessment of Dehydration (WHO Criteria) • No dehydration • Some dehydration • Severe dehydration Statistical Analysis Data analyzed using SPSS software. Chi-square test applied. p < 0.05 considered significant.

Demographic Profile

Out of 200 children, the mean age was 2.4 ± 1.3 years. Males constituted 60% and females 40% of the study population.

Clinical Presentation

All children presented with diarrhea (100%). Vomiting was seen in 72% of cases, while fever was present in 48%. Other symptoms included abdominal pain (30%) and lethargy (25%).

Dehydration Status

No dehydration was observed in 40% of children, some dehydration in 46%, and severe dehydration in 14% of cases.

Feeding Practices

Exclusive breastfeeding was observed in only 38% of children. Bottle feeding was reported in 42% of cases and was significantly associated with higher severity of dehydration (p < 0.05).

Sanitation and Hygiene

Poor sanitation and use of unsafe drinking water were reported in 55% of cases and were significantly associated with increased severity of illness.

Immunization Status

Incomplete immunization was noted in 30% of children and showed a higher incidence of severe gastroenteritis.

The present study highlights that acute gastroenteritis continues to be a major cause of morbidity among under-five children. The high prevalence in younger children may be attributed to immature immunity and poor hygiene practices.

Vomiting and fever were common associated symptoms, consistent with previous studies. A significant proportion of children presented with some degree of dehydration, emphasizing the importance of early recognition and management.

Bottle feeding and lack of exclusive breastfeeding were identified as major risk factors, likely due to increased exposure to contaminated feeds. Poor sanitation further exacerbates the risk of infection.

These findings underscore the importance of preventive strategies such as promoting breastfeeding, improving hygiene, and ensuring safe drinking water.

Acute gastroenteritis remains a significant health concern in under-five children. Modifiable risk factors such as feeding practices, sanitation, and immunization status play a crucial role in disease severity. Public health interventions targeting these factors can significantly reduce disease burden. Limitations • Single-center study • Lack of microbiological confirmation • Recall bias in history Recommendations • Promote exclusive breastfeeding • Improve sanitation and safe water supply • Strengthen immunization coverage Educate caregivers on oral rehydration therapy

1. World Health Organization. Diarrhoeal disease. WHO; 2013.
2. Black RE, Cousens S, Johnson HL, et al. Global child mortality. Lancet. 2010;375:1969–1987.
3. Walker CLF, Perin J, Aryee MJ, et al. Global burden of diarrhea. Lancet. 2012;381:1405–1416.
4. Fischer Walker CL, Rudan I, Liu L, et al. Global burden of childhood pneumonia and diarrhea. Lancet. 2013;381:1405–1416.
5. Boschi-Pinto C, Velebit L, Shibuya K. Estimating mortality due to diarrhea. Bull WHO. 2008;86:710–717.
6. Kosek M, Bern C, Guerrant RL. Global burden of diarrheal disease. Bull WHO. 2003;81:197–204.
7. Checkley W, Buckley G, Gilman RH, et al. Multi-country study of diarrhea. Lancet. 2008;371: 1809–1818.
8. Thapar N, Sanderson IR. Diarrhea in children. Lancet. 2004;363:641–653.
9. Victora CG, Bryce J, Fontaine O, et al. Reducing deaths from diarrhea. Bull WHO. 2000;78:1246–1255.
10. Fontaine O. Effect of zinc supplementation. J Pediatr. 2001;138:649–653.
11. Bhan MK. Bacterial and viral diarrhea. Indian J Pediatr. 2000;67:139–144.
12. Guerrant RL, Van Gilder T, Steiner TS, et al. Practice guidelines for diarrhea. Clin Infect Dis. 2001;32:331–351.
13. Munos MK, Walker CLF, Black RE. Interventions for diarrhea mortality. Lancet Infect Dis. 2010;10:567–577.
14. Bhutta ZA, Black RE, Brown KH, et al. Zinc supplementation. J Pediatr. 1999;135:689–697.
15. Glass RI, Parashar UD, Estes MK. Norovirus gastroenteritis. N Engl J Med. 2009;361:1776–1785.
16. Tate JE, Burton AH, Boschi-Pinto C, et al. Rotavirus mortality. Lancet Infect Dis. 2012;12:136–141.
17. Brown KH. Diarrhea and malnutrition. J Nutr. 2003;133:328S–332S.
18. Keusch GT, Fontaine O, Bhargava A, et al. Diarrheal diseases. In: Disease Control Priorities; 2006.
19. Lamberti LM, Fischer Walker CL, Noiman A, et al. Breastfeeding and diarrhea. BMC Public Health. 2011;11:S15.
20. WHO/UNICEF. Clinical management of acute diarrhea. WHO; 2004.