EPIDEMIOLOGY , PREVENTION &

CONTROL OF ACUTE DIARRHOEAL DISEASE

PRESENTED BY:

SWAPNIL SHUKLA

PARA -H2 ROLL NO : 136

G.S.V.M MEDICAL COLLEGEDepartment of community medicine

What is diarrhoea?

Passage of 3 or more loose , liquid or watery stools in a day.

What is not diarrhoea? 1: Frequent formed stools 2: Pasty stools in breastfed child 3: Stools during or after feeding 4: PSEUDODIARRHOEA: small volume of stools

frequently ( IBS)

TYPES

o ACUTE DIARRHOEA : <2 weeks , the main danger is dehydration,90% attacks are self limited (resolved by ORS).

o PERSISTENT DIARRHOEA : 2-4 weeks.main danger is malnutrition and serious non intestinal infection.

o DIARRHOEA WITH SEVERE MALNUTRITION(marasmus & kwashiorkor):- main dangers are severe systemic infection, dehydration, heart failure and vitamin & mineral deficiency.

o ACUTE BLOODY DIARRHOEA:-also called as dysentery-main dangers are damage of intestinal mucosa,sepsis and malnutrition.

1.2-1.9 episodes per person annually in the general population.

2.4 episodes per child < 3 years old annually.

5 episodes per year for children < 3years old and in daycare.

Seasonal peak in the winter

Epidemology

PROBLEM STATEMENT When the WHO initiated the diarrhoeal

control programme in 1980,appoximetely 4.6 milion children uesd to die each year of the dehydration caused by diarrhoea.

In India,acute diarrhoeal disease accounts for about 8% of deaths under-5 years age group.

During the year 2013,about 10.7 milion cases with 1535 deaths were reported in in india.

BACTERIA VIRUS

Vibrio cholera Rotavirus Shigella Adenovirus

E.coli Astrovirus

Salmonella

Staphylococcus

Yersinia

COMMON CAUSES – BACTERIA AND VIRUS

Fluid replacement to prevent dehydration. Zinc treatment. Rotavirus and measles vaccinations. Promotion of early and exclusive

breastfeeding and vitamin A supplementation. Promotion of hand washing and soap. Improved water supply quality and quantity , Including treatment and safe storage of

household water. Community-wide sanitation promotion. Fly control

PLAN FOR COMPREHENSIVE DIARRHOEA CONTROL

With introduction of oral rehydration by WHO it is now Firmly established that oral rehydration treatment can be safely and successfully used in treating acute

diarrhoeas due to all aetiologies ,in all age groups ,and

In all countries.

ORAL REHYDRATION THERAPY

INGREDIENTS AMOUNT( GMS PER LITRE)

SODIUM CHLORIDE

2.6

GLUCOSE 13.5POTASSIUM CHLORIDE

1.5

TRISODIUM CITRATE

2.9

COMPOSITION OF WHO-ORS

After appropriate treatment of diarrhoea zinc supplementation can prevent the occurrence of diarrhoea for the following 2-3

months

ZINC SUPPLEMENTATION

Immunization against measles is a potential intervention for diarrhoea control.

When administered at the recommended age , the measles vaccine can prevent upto 25% of diarrhoea deaths in children under 5 years of age

All children who have been immunized against measles was protected from diarrhoea to an extent.

IMMUNIZATION

EXCLUSIVE BREAST FEEDING – no other food or drink is given.

An infant should be exclusively breastfed for first six months of life.

Majority of breastfed children do not suffer from diarrhoea.

Breast milk contains several anti infective factors which protect the baby from enteral infection

BREAST FEEDING

Park's textbook of Preventive and social Medicine ( 23rd edition)

REFERENCES

THANKYOU