Diarrhea is the second leading killer of children under the age of five around the world, accounting for approximately 15% of under-five child deaths worldwide, or almost two million deaths annually according to WHO (2003).
What is diarrhoea?
Diarrhea is the passage of loose or watery stools occurring three or more times in a 24-hour period.
The three types of diarrhea are: acute diarrhea, persistent diarrhea, and dysentery.
If an episode of diarrhea lasts less than 14 days, it is acute diarrhea. Acute watery diarrhea causes dehydration and contributes to malnutrition. The death of a child with acute diarrhea is usually due to dehydration.
If the diarrhea lasts 14 days or more, it is persistent diarrhea. Up to 20% of episodes of diarrhea become persistent. Persistent diarrhea often causes nutritional problems, creating the risk of malnutrition and serious non-intestinal infection. Dehydration also occurs.
Diarrhea with blood in the stool- with or without mucus-is called dysentery. Dysentery is very dangerous because of its ability to lead to anorexia, rapid weight loss, and damage to the intestinal mucosa. Another danger is sepsis.
Though the global under-five mortality from acute diarrhea has decreased from 4.5 million to 1.8 million annually, acute diarrhea continues to take a huge toll on children’s health in developing countries. (WHO 2006). Diarrhea represents a significant burden on the health system, the household, and the nutritional status of children.
The management of each type of diarrhoea should prevent or treat the main danger(s) that each presents.
Why diarrhoea is dangerous
When a child has diarrhoea the body fluids and salts can be quickly lost from the body. The child becomes dry (dehydrated) and this is very dangerous and may kill the child.
Diarrhoea causes rapid depletion of water and sodium – both of which are necessary for life. If the water and salts are not replaced fast, the body starts to “dry up” or get dehydrated. If more than 10% of the body’s fluid is lost, death occurs.
Severe dehydration can cause death.
The cause
Diarrhoea is a symptom of infection caused by a host of bacterial, viral and parasitic organisms most of which can be spread by contaminated water. It is more common when there is a shortage of clean water for drinking, cooking and cleaning and basic hygiene is important in prevention.
Water contaminated with human faeces for example from municipal sewage, septic tanks and latrines is of special concern. Animal faeces also contain microorganisms that can cause diarrhoea.
Diarrhoea can also spread from person to person, aggravated by poor personal hygiene. Food is another major cause of diarrhoea when it is prepared or stored in unhygienic conditions. Water can contaminate food during irrigation, and fish and seafood from polluted water may also contribute to the disease.
Distribution
The infectious agents that cause diarrhoea are present or are sporadically introduced throughout the world. Diarrhoea is a rare occurrence for most people who live in developed countries where sanitation is widely available, access to safe water is high and personal and domestic hygiene is relatively good. World-wide around 1.1 billion people lack access to improved water sources and 2.4 billion have no basic sanitation. Diarrhoea due to infection is widespread throughout the developing world. In Southeast Asia and Africa, diarrhoea is responsible for as much as 8.5% and 7.7% of all deaths respectively.
Scope of the Problem
Amongst the poor and especially in developing countries, diarrhoea is a major killer. In 1998, diarrhoea was estimated to have killed 2.2 million people, most of whom were under 5 years of age (WHO, 2000). Each year there are approximately 4 billion cases of diarrhoea worldwide.
Prevention
Diarrhoea can be prevented by pursuing multisectoral efforts by:
improving access to clean water and safe sanitation promoting hygiene education exclusive breast-feeding
improved weaning practices immunizing all children; especially against measles using latrines keeping food and water clean washing hands with soap (the baby’s as well) before touching food and by sanitary disposal of stools.
These tips can help parents and communities as well to prevent almost all of these deaths and most of the malnutrition caused by diarrhoea.
