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                                Diarrhoea

                                  Overview

                                  Diarrhoeal disease is the second leading cause of death in children under five years old, and was responsible for the deaths of 370,000  children in 2019. The most severe threat posed by diarrhoea is dehydration. During an episode of diarrhoea, water and electrolytes including sodium, chloride, potassium and bicarbonate are lost through liquid stools, vomit, sweat, urine and breathing. A person with diarrhoea becomes dehydrated when these losses are not replaced. In addition, diarrhoea is a major cause of malnutrition, making the person more susceptible to future bouts of diarrhoea and to other diseases.

                                  There are three clinical types of diarrhoea, each with its specific treatments:

                                  • Acute watery diarrhoea, which may last several hours or days, and includes cholera.
                                  • Acute bloody diarrhoea, also called dysentery.
                                  • Persistent diarrhoea, lasting 14 days or longer.

                                  In the past, for most children, severe dehydration and fluid loss were the main causes of dying from diarrhoea. Now, other causes such as septic bacterial infections are likely to account for an increasing proportion of all diarrhoea-associated deaths. 

                                  Exclusive breastfeeding is protective and prevents diarrhoea from occurring in young children. Breastfeeding also reduces the severity of diarrhoea.

                                  Innovative activities and demand creation are important for achieving behaviour change and sustaining long-term preventive practices to combat preventable morbidity and mortality from diarrhoeal diseases. 

                                  Symptoms

                                  Diarrhoea is the passage of 3 or more loose or liquid stools per day, or more frequently than is normal for the individual. It is usually a symptom of gastrointestinal infection, 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.

                                   
                                  Treatment

                                  Key measures to prevent diarrhoea include the following:

                                  • 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 diarrhoea include the following:

                                  • Rehydration with oral rehydration salts (ORS) solution: ORS, particularly the low osmolarity formula, are a proven life-saving commodity for the treatment of children with diarrhoea.
                                  • Rehydration may require intravenous fluids in case of severe dehydration or shock.
                                  • Zinc supplements reduce the duration of a diarrhoea episode by 25% and are associated with a 30% reduction in stool volume.
                                  • Nutrient-rich foods: the vicious circle of malnutrition and diarrhoea can be broken by continuing to give nutrient-rich foods – including breast milk – during an episode, and by giving a nutritious diet – including exclusive breastfeeding for the first six months of life – to children when they are well.
                                  • Consulting a health professional, in particular for management of persistent diarrhoea, or when there is blood in the stool, or if there are signs of dehydration.
                                  • Adequate nutrition is key to improving natural defenses, starting with exclusive breastfeeding for the first 6 months of life.

                                   

                                  525 000 deaths

                                  each year

                                  Each year diarrhoea kills around 525 000 children under five.

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                                  1.7 billion cases

                                  of diarrhoea

                                  Globally, there are nearly 1.7 billion cases of childhood diarrhoeal disease every year.

                                  Find out more

                                  1 of 4 key causes

                                  of diarrhoea

                                  Salmonella is 1 of 4 key global causes of diarrhoeal diseases.

                                  Find out more

                                  Publications

                                  2019, Cholera, ICG annual meeting report

                                  The annual meeting of the International Coordinating Group (ICG) on Vaccine Provision for cholera was held on 11 September at the headquarters of the International...

                                  Ending Preventable Child Deaths from Pneumonia and Diarrhoea by 2025

                                  Stopping the loss of millions of young lives from pneumonia and diarrhoea is a goal within our grasp. The integrated Global Action Plan for the Prevention...

                                  Short-term effects of breastfeeding: a systematic review on the benefits of breastfeeding on diarrhoea and pneumonia mortality

                                  This review and meta-analysis assesses the effect of breastfeeding on respiratory infections and diarrhoeal disease in children younger than 5 years of...

                                  WHO recommendations on the management of diarrhoea and pneumonia in HIV-infected infants and children

                                  To improve survival and quality of life among the 2.5 million children living with HIV, a comprehensive package of prevention, care and treatment is required....

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                                  Dr Yasir Bin Nisar
                                  Medical Officer

                                  Dr Bernadette M. E
                                  Unit Head