Diarrhea Prevention-Introduction,Effects of Diarrhea

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Gastrointestinal Disorders in Children

Prevention of Diarrhea

Gastrointestinal Disorders in Children

Zinc and ORS

Acute Diarrhea in Children

Inflammatory Bowel Disease/IBD

Acute Childhood Diarrhea: Review of Recent Advances in Standard Management

Zinc For The Prevention Of Diarrhea

Oral Rehydration Therapy

Approach To Acute Abdominal Pain In Children

Trachea oesophageal fistula

Vomiting and Diarrhea in Children

Upper Gastrointestinal bleed

ORS - Which one to use?

Acute Abdomen

Malabsorption syndromes

Prevention of Diarrhea

Lactose Intolerance in Infants, Children, and Adolescents

Biliary Atresia and Kasai's Surgery - When is it too Late

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Diagnostic Aid

VACCINE REMINDER

"Get the Vaccine Schedule for your child."

Ask Queries

SPECIALIST ANSWERS

Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

PREVENTION OF DIARRHEA

Related topics

Steps For Prevention Of Diarrhea

Breast-Feeding

Improved Weaning Practices

Proper Use Of Water For Hygiene and Drinking

Zinc Supplementation

A Gaffar Billoo, Saira Waqar Ahmed
Department of Pediatrics, Aga Khan University Karachi, Pakistan

Address for Correspondence:

Professor A Gaffar Billoo, Department of Pediatrics, Aga Khan University Karachi, Pakistan. Email : gaffar.billoo@aku.edu

Introduction

Diarrhea is the second among the most common causes of death in children. Death is usually due to loss of fluid and electrolytes. It is an important factor in development of malnutrition. It is one of the principal causes of morbidity and mortality among children in the developing world. About 4 billion episodes of diarrhea / year cause 1.5 million deaths mostly in children <5 yrs.

For children under 5 years of age in developing areas and countries, there is a median of 3.2 episodes of diarrhea/child/year. This mortality study revealed that 4.9 children per 1000 per year in these areas and countries died as a result of diarrheal illness in the first 5 years of life, a decline from the previous estimates of 13.6 and 5.6 per 1000 per year. The decrease was most pronounced in children aged less than 1 year. Despite improving trends in mortality rates, diarrhea continues to account for a median of 15% of all deaths of children aged less than 5 years in these areas and countries, being responsible for 1.5 million deaths per year. (fig.1)

The major cause of concern is that there has not been a concurrent decrease in morbidity rates attributable to diarrhea. As population growth is focused in the poorest areas, the total morbidity component of the disease burden is greater than previously ¹

In 1982, on the basis of a review of active surveillance data from studies conducted in the 1950s, 1960s and 1970s, it was estimated that 4.6 million children died annually from diarrhea. In 1992, a review of studies conducted in the 1980s suggested that diarrheal mortality had declined to approximately 3.3 million annually. Both reviews estimated that children in the developing world experienced a median of 3 episodes of diarrhea every year.

Most interventions for diarrheal disease, e.g. increased breastfeeding, better weaning practices, clean water, improved sanitation and higher rates of measles immunization, would be expected to affect mortality as well as morbidity simultaneously. Nutritional status is another factor that may help to explain the de-linking of diarrheal mortality and morbidity rates. The use of oral rehydration therapy is an exception, its increased use over the past two decades probably having been responsible for some of the decrease in case-fatality rates, especially from acute dehydrating diarrhea (2).

In order to achieve further declines in mortality it may be necessary to adopt a more complex approach that would include distinguishing acute watery diarrhea, dysentery and persistent diarrhea, and ensuring appropriate case management for each syndrome. These issues are specifically addressed in the WHO/UNICEF initiative for the improved management of childhood illness (3).

Diarrhea thus still accounts for 1.5 million deaths annually, and each child in the developing world experiences an average of three episode of diarrhea per year. (fig.2)