Traditional Remedy Sagwa as a Risk Factor for Severe Morbidity and Mortality in Iraqi Infants with Acute Diarrhea. A Case–Control Study

<ns7:p> Background Using herbal medicine and supplements in treatment of pediatric diarrhea is used by around 80% of people worldwide. Sagwa is popularly used mainly in rural areas in Iraq. Potential toxicity may include neurotoxic, hepatotoxic, nephrotoxic and cardiotoxic effects. Aim This study was carried out to determine the morbidity and mortality linked to Sagwa use in acute gastroenteritis in infants with contributing factors. Patients and Methods A prospective case-control study in Al-Fallujah, Iraq from July 1 <ns7:sup>st</ns7:sup> , 2022, to Jan 1 <ns7:sup>st</ns7:sup> , 2023. The participants were infants with acute diarrhea who were admitted to pediatric wards and emergency departments. The cases were those infants with diarrhea who have been given Sagwa. Controls were age- and sex-matched who had acute diarrhea without use of Sagwa. The data of patients included: the number of times of having Sagwa, the duration between exposure and hospital admission, duration of hospital stay, the grandmother responsibility, the severity of dehydration, the presence of renal failure, the need for dialysis, convulsion, coma and death. Results The study included 50 cases and 50 controls. No significant differences in age and sex were observed but there was a significant association with rural residence, not educated mothers, grandma responsibility, severe dehydration, convulsions, and death. No significant differences were observed considering renal failure, dialysis and coma. A highly significant association was observed between oral &amp; scalp administration routes and convulsions and renal failure. Conclusion Sagwa use in infants with diarrhea is dangerous and contributes to morbidity and mortality which are preventable. Cultural education against its use should target mothers and grandmothers in rural areas. </ns7:p>