Childhood diarrhoeal disease continues to be one of the major killers among under five children in many states contributing to 10 percent of under five deaths in the country. Almost all the deaths due to diarrhoea can be averted by preventing and treating dehydration by the use of ORS (Oral Rehydration Solution) and administration of zinc tablets along with adequate nutritional intake by the children during diarrhoea. IDCF(Intensified Diarrhoea Control Fortnight) is being implemented for the last five years, reaching out to millions of children, with the ultimate of Zero child deaths due to diarrhoea. In 2019 also, it has been decided to implement IDCF from 28th May to 8th June 2019 to intensify efforts towards reducing deaths due to diarrhoea among under 5 children. During IDCF, several activities will be carried out which includes intensification of advocacy and awareness generation activities for diarrhoea management, strengthening service provision for diarrhoea case management, establishment of ORS-Zinc corners at Health facilities, distribution of ORS by ASHA to household with under five children and awareness generation activities for sanitation and hygiene.
Types of Diarrhoea in Children?
Acute Diarrhoea:: Is an episode of diarrhoea that lasts less than 14 days. Acute watery diarrhoea causes dehydration and contributes to malnutrition. The death of a child with acute diarrhoea is usually due to dehydration
Persistant Diarrhoea:: If an episode of diarrhoea that lasts for 14 days or more. [Up to 20% of episodes of diarrhoea become persistent, and this often causes nutritional problems and contributes to death in children
Dysentary:: Diarrhoea with blood in the stool, with or without mucus. Themost common cause of dysentery is Shigella bacteria. Amoebic dysentery is not common in young children. A child may have both watery diarrhoea and dysentery.
1. What is Dehydration?
Diarrhoea can be a serious problem – and even lead to death – if child becomes dehydrated. Dehydration is when the child loses too much water and salt from the body. This causes a disturbance of electrolytes, which can affect vital organs.
A child who is dehydrated must be treated to help restore the balance of water and salt. Many cases of diarrhoea can be treated with Oral Rehydration Salts (ORS), a mixture of glucose and several salts. ORS and extra fluids can be used as home treatment to prevent dehydration. Low osmolarity ORS should be used to treat dehydration.
How to assess Dehydration?
1. Restless or irritable.
2. The eyes may look sunken
3. Skin loses elasticity and
4. If dehydration continues, the child becomes lethargic or unconscious.
Key Steps in Managing Diarrhoea in Children.
4 key interventions: Manage a case of childhood diarrhoea
1. Rehydrate the child with ORS solution (in case of no-dehydration breast feed the child frequently, ORS and clear fluid at home, in case of some dehydration give ORS, Zinc supplement and food at health facility level) or with IV fluids (in case of severe dehydration use of IV fluids at health facility). Stop rehydration once diarrhoea stops.
2. Administer Zinc dispersible tablets for 14 days, even after diarrhoea stops.
3. Continued age appropriate feeding.
4. Rational use of antibiotics
Note: In case of Acute Dehydration and Diarrhoea only use the ORS mixture found in powdered form sold in the Pharmacy with World Health Organisation (WHO) stamp.
Dr. Kevichusa Medikhru
The writer is a Mission Director, National Health Mission