I need information about Diarrhoeal disease

Compliments of the season to our committed and able doctor. Recently in the northern parts of Nigeria, a lot of adults and children suffered from diarrhoeal disease. Kindly provide information including preventive measures.

Janet K.

Thanks Janet for your question. According to the World Health Organisation (WHO), diarrhoeal disease is the second leading cause of death in children under five years old. Each year diarrhoea kills around 525,000 children under five. A significant proportion of diarrhoeal disease can be prevented through safe drinking-water and adequate sanitation and hygiene. And it is the leading cause of malnutrition in children under five years old.

Diarrhoea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual). Frequent passing of formed stools is not diarrhoea, nor is the passing of loose, “pasty” stools by breastfed babies. Diarrhoea is usually a symptom of an infection in the intestinal tract, which can be caused by a variety of bacterial, viral and parasitic organisms. Infection is spread through contaminated food or drinking-water, or from person-to-person as a result of poor hygiene.

Interventions to prevent diarrhoea, including safe drinking-water, use of improved sanitation and hand washing with soap can reduce disease risk. Diarrhoea should be treated with oral rehydration solution (ORS), a solution of clean water, sugar and salt. In addition, a 10-14 day supplemental treatment course of dispersible 20mg zinc tablets shortens diarrhoea duration and improves outcomes.

Types of Diarrhoea

-Acute watery several hours or cholera;

-Acute bloody diarrhoea – also called dysentery

-Persistent diarrhoea – lasts 14 days or longer. Dehydration The most severe threat posed by diarrhoea is dehydration. During a diarrhoeal episode, water and electrolytes (sodium, chloride, potassium and bicarbonate) are lost through liquid stools, vomit, sweat, urine and breathing. Dehydration occurs when these losses are not replaced.

The degree of dehydration on a scale of three.

Severe dehydration has at least two of the following signs • lethargy/unconsciousness • sunken eyes diarrhoea days, and – lasts includes is rated • unable to drink or drink poorly

skin pinch goes back very slowly 2 seconds) Some dehydration (two or more of the following signs: • restlessness, irritability • sunken eyes • drinks eagerly, thirsty No dehydration (not enough signs to classify as some or severe dehydration) (

Causes;

• Infection: Diarrhoea is a symptom of infections caused by a host of bacterial, viral and parasitic organisms, most of which are spread by faecescontaminated water. Infection is more common when there is a shortage of adequate sanitation and hygiene and safe water for drinking, cooking and cleaning. Rotavirus and Escherichia coli, are the two most common etiological agents of moderate-tosevere diarrhoea in low-income countries. • Malnutrition: Children who die from diarrhoea often suffer from underlying malnutrition, which makes them more vulnerable to diarrhoea. Each diarrhoeal episode, in turn, makes their malnutrition even worse. • Source: Water contaminated with human faeces, for example, from sewage, septic tanks and latrines, is of particular concern. Animal faeces also contain microorganisms that can cause diarrhoea. • Other causes: Diarrhoeal disease 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. Unsafe domestic water storage and handling is also an important risk factor.

Prevention and treatment

Key measures diarrhoea include: • Access to safe drinking-water. • Use of improved sanitation. • Hand washing with soap. • Exclusive breastfeeding for the first six months of life. • Good personal and food hygiene. • Health education about how infections spread. • Rotavirus vaccination. Key measures to treat include the following

• Rehydration: with oral rehydration salts (ORS) solution. ORS is a mixture of clean water, salt and sugar. It costs a few naira per treatment. ORS is absorbed in the small intestine and replaces the water and electrolytes lost in the faeces.

• Zinc supplements: zinc supplements reduce the duration of a diarrhoea episode by 25% and are associated with a 30% reduction in stool volume.

• Rehydration: with intravenous fluids in case of severe dehydration or shock. to prevent diarrhoea