Diarrhea:
Diarrhoea occurs world-wide and causes 4% of all deaths and 5% of health loss to disability. It is most commonly caused by gastrointestinal infections which kill around 2.2 million people globally each year, mostly children in developing countries. The use of water in hygiene is an important preventive measure but contaminated water is also an important cause of diarrhoea. Cholera and dysentery cause severe, sometimes life threatening forms of diarrhea.
The disease and how it affects people:
Diarrhoea is the passage of loose or liquid stools more frequently than is normal for the individual. It is primarily a symptom of gastrointestinal infection. Depending on the type of infection, the diarrhea may be watery (for example in cholera) or passed with blood (in dysentery for example).
Diarrhoea due to infection may last a few days, or several weeks, as in persistent diarrhea. Severe diarrhea may be life threatening due to fluid loss in watery diarrhea, particularly in infants and young children, the malnourished and people with impaired immunity.
The impact of repeated or persistent diarrhea on nutrition and the effect of malnutrition on susceptibility to infectious diarrhea can be linked in a vicious cycle amongst children, especially in developing countries.
Diarrhea is also associated with other infections such as malaria and measles. Chemical irritation of the gut or non-infectious bowel disease can also result in diarrhea.
The cause:
Diarrhea 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 diarrhea.
Diarrhea can also spread from person to person, aggravated by poor personal hygiene. Food is another major cause of diarrhea 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 diarrhea are present or are sporadically introduced throughout the world. Diarrhea 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. Diarrhea due to infection is widespread throughout the developing world. In Southeast Asia and Africa, diarrhea 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, diarrhea is a major killer. In 1998, diarrhea 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 diarrhea worldwide.
Interventions
Key measures to reduce the number of cases of diarrhea include:
- Access to safe drinking water.
- Improved sanitation.
- Good personal and food hygiene.
- Health education about how infections spread.
- Key measures to treat diarrhea include:
- Giving more fluids than usual, including oral rehydration salts solution, to prevent dehydration.
- Continue feeding.
- Consulting a health worker if there are signs of dehydration or other problems.
