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K.G.M.U, Lucknow.
WHAT IS DIARRHOE?
Diarrhea is the passage of loose, liquid or watery
stool.
In many regions Diarrhea is defined as passage of
three or more loose or watery stools in 24 hour
period.
However it is the recent change in consistency and
character of stool than the number of stools that is
more important.
In most cases the mother knows what is abnormal
stool for her child.
It is a killer disease in children.
One in four deaths in children under the age of 5yrs.
is due to diarrhea.
WHAT CAUSES DIARRHOEA?
Infectious Disease Agents Causing Diarrhoea.
BACTERIA
1. Escherichia coli
It produces heat labile (LT) and heat stable (ST)
entertoxins.
E.COLI - COULD BE
Enteropathogenic- Causes infantile diarrhoea.
Entero toxigenic – Causes travellers diarrhoea.
Enteroinvasive- Dysentery type of diarrhoea.
Enteroadherent
Enterohaemorrhagic
VIBRIO CHOLERAE- produces enterotoxins
Vibrio para haemolyticus- Invasive.
Non-Cholerae vibrios
WHAT CAUSES DIARRHOEA?
Infectious Disease Agents
SHIGELLAE–Invasive, produce bloody diarrhoea or
Dysentery.
CAMPYLOBACTER JEJUNI – invasive.
SALMONELLAE OTHER THAN S.TYPHI- invasive.
AGENT FACTORS
HOST FACTORS
ENVIRONMENTAL FACTORS
RESERVOIR OF INFECTION.
HOW MANY TYPES OF
DIARRHOEA ARE THERE?
PERSISTENT DIARRHOEA.
HOW SHOULD ACUTE WATERY
DIARRHOEA IN CHILDREN BE MANAGED?
ASSESSMENT OF DEHYDRATION
FLUID THERAPY
FLUID THERAPY IN DIARRHOEA
WHAT IS THE PURPOSE OF FLUID THERAPY.
- ORS
Basis of ORS
OTHER FLUIDS
HAF
Prevention of dehydration
Correction of dehydration
Maintenance of hydration
Chemotherapy
Restoration of Nutritional Status.
Diarrhoea- Leads to malnutrition
Increase in Breast feeding frequency
Increase in diet.
OTHER PREVENTIVE STRATEGIES?
Vitamin –A prophylaxis
Improved Nutrition
Immunization
- Measles immunization
ROTA VIRUS VACCINE
Two live oral attenuated rotavirus vaccines were licensed
in 2006. Now there are three.
Monovalent human rotavirus vaccine (Rotarix).
The pentavalent bovine- Human reassortant vaccine
(Rota Teq)
They Provide 75-80% protection against rotavirus
diarrhoea
and 90-100% protection against rotavirus disease.
WHAT ARE THE NATIONAL PROGRAMS
FOR DIARRHOEA IN INDIA
National diarrhoeal disease control program
(NDDCP)