Diarrhoea, Diarrhea, Dehydration and Oral Rehydration - Rehydration Project home

Diarrhoea Kills a Child Every 26 Seconds
 


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Clear, practical advice on preventing and treating diarrhoeal diseases. Guidelines from medical authorities on diagnosis, treatment, symptoms, causes and risk factors, tests, training tips, feedback from the field, alternative medicine and much more for patients and health professionals. News on developments in the control, management, treatment and prevention of diarrhoeal diseases.


"Diarrhea is the world’s most effective weapon of mass destruction."
Rose George, The Big Necessity: The Unmentionable World of Human Waste and Why it Matters | TED Talk: Let's talk crap. Seriously.


Children with diarrhoea are at risk of dying due to dehydration, and early and appropriate fluid replacement is a main intervention to prevent death. Yet few children with diarrhoea in developing countries receive appropriate treatment with oral rehydration therapy and continued feeding (39 per cent).

Even fewer receive solutions made of oral rehydration salts (ORS) alone (one-third), and the past decade has seen no real progress in improving coverage across developing countries.

Moreover, the poorest children in the poorest countries are least likely to use ORS, and zinc treatment remains largely unavailable in high-mortality countries. The stagnant low ORS coverage over the past decade indicates a widespread failure to deliver one of the most cost-effective and life-saving child survival interventions and underscores the urgent need to refocus attention and funding on diarrhoea control."


Source: UNICEF - Pneumonia and diarrhoea: Tackling the deadliest diseases for the world’s poorest children



International Society for Social Pediatrics and Child Health (ISSOP) Position Statement on sponsorship of paediatricians/paediatric societies by the Baby Feeding Industry

Infant and young child feeding is central to child health and, after birth, breastfeeding is the first act of provision by a mother for her child. For most of history no other third party was required to support infant feeding other than the mother and the surrounding family. It is only since the commercial development of breast milk substitutes in the nineteenth century that health professionals have become involved in their prescription.

ISSOP "In recent years, the commercialisation of infant feeding has impacted on professional practice through the development of sponsorship by the Baby Feeding Industry of medical conferences and meetings, along with gifts to health workers.

It is the view of ISSOP that this sponsorship is damaging to the reputation of paediatricians, to the health of mothers and infants, and to the status of breastfeeding and this statement explains the reasons why we believe that such sponsorship should be terminated."

>> Download ISSOP Position Statement

ISSOP is hopeful that the Position Statement will be used with paediatric societies and associations around the world to ensure that paediatricians and other health professionals avoid conflicts of interest, and protect breastfeeding as one of the most health promoting measures in the field of child health.

*The term Baby Feeding Industry refers to all commercial companies which market infant formula or other infant feeding products.


doctoori.net - reliable health information in Arabic

doctoori.netwww.doctoori.net brings to you, high quality, reliable health information in the Arabic language, through our syndicated partnership with NHS Choices. Our engaging, patient focused articles and interactive tools provide an invaluable, trusted health resource for you and your family.

يقدم لك دكتوري معلومات صحية ذات جودة عالية وموثوقة باللغة العربية من خلال شراكتنا في المقالات مع NHS Choices . تقدم مشاركتنا، المقالات التي تركز على المريض، والأدوات التفاعلية لمواردنا الصحية موثوقة ولاتقدر بثمن لك ولعائلتك.  


IWC Masters Scholarships - Integrated Water Management

IWC Masters Scholarships - Integrated Water ManagementThe International WaterCentre (IWC) is currently offering several full scholarships for high calibre candidates to study the IWC Master of Integrated Water Management (MIWM) in Australia next year.

  • Scholarships applications now open for international students*
  • Up to four international scholarships will be offered including two full scholarships (each valued at AUD$ 79,311 including living expenses) and up to two full tuition scholarships (each valued at AU$ 50,776)
  • Apply for a scholarship by 1 August 2014
  • Enrol at The University of Queensland (Australia) and start the MIWM program in February 2015

Using practical learning approaches, MIWM students create and implement integrated solutions to global and local water challenges. The degree is co-badged and co-taught by IWC's four founding member universities: The University of Queensland, Griffith University, Monash University and The University of Western Australia.

* Domestic scholarships will open later this year (from 1 July until 1 October). Domestic students are Australian citizens, New Zealand citizens and Australian permanent residents. International students are all other students

More information  www.watercentre.org/scholarships - Register for our upcoming webinar: Dr Brian McIntosh, IWC Senior Lecturer and Education Program Manager, will present the MIWM program and scholarships and answer your questions on Wednesday 2 July.
Download Flyer | Register today | Contact Email admin@watercentre.org | phone +61 7 3014 0200


Treatment of diarrhea in young children: results from surveys on the perception and use of oral rehydration solutions, antibiotics, and other therapies in India and Kenya

Journal of Global Health - 2013 June; 3(1): 010403. - doi: 10.7189/jogh.03.010403
Diarrheal disease is a leading cause of morbidity and mortality among children under five. Although oral rehydration solution (ORS) has tremendous therapeutic benefits, coverage of and demand for this product have remained low in many developing countries. This study surveyed caregivers and health care providers in India and Kenya to gather information about perceptions and use of various diarrhea treatments, assess reasons for low ORS use, and identify opportunities for expanding ORS use.

"Children are dying for lack of basic healthcare knowledge among citizens and health workers, and this is especially true of children with diarrhoea. Previous studies have shown that only 1 in 10 children with diarrhoea in India receive increased fluids to prevent death from dehydration, contributing to more than a million deaths every year. Almost 4 in 10 receive less to drink than normal, thereby tragically *increasing* their risk of death as compared with carrying on as normal. By contrast, more than 1 in 3 are inappropriately given antibiotics, which are not generally recommended for childhood diarrhoea.

A thousand children die needlessly from diarrhoea every day in India alone, due to basic errors in care from parents and health workers.
See: This new paper from India and Kenya provides further cause for concern... More than 90% of all diarrhea deaths could potentially be avoided with universal coverage of ORS - A million children are dying unnecessarily from diarrhoea every year because of lack of basic healthcare knowledge... How can we do better to improve the knowledge of citizens and health workers to manage child diarrhoea more effectively?" Join HIFA2015 and Discuss - It's Free!


What every health worker, family and community has a right to know

HealthPhone™ Essentials: Educational Videos for Basic Health Knowledge in Hindi

HealthPhone™ Essentials: Educational Videos for Basic Health Knowledge in Hindi

Early and Exclusive Breastfeeding
Hand Washing with Soap and Water
Use of Oral Rehydration Salts (ORS) and Zinc
Routine Immunization
Initiation of Breastfeeding by Breast Crawl


New US and Australian intussusception data: benefits of vaccination outweigh risks CDC continues to recommend that all US infants receive rotavirus vaccine
22 June, 2013 - The United States (US) Advisory Committee on Immunization Practices (ACIP) met on June 20, 2013 at the US Centers for Disease Control and Prevention (CDC) to discuss new US and Australian intussusception data and CDC’s summary of the risks and benefits of rotavirus vaccination. In CDC’s presentation to ACIP, officials summarized the known risks and benefits of rotavirus vaccination and concluded that the benefits continue to outweigh the risks, including the risk of intussusception. CDC did not suggest any changes to the US rotavirus immunization schedule due to the new intussusception data and continued to recommend that all US infants receive rotavirus vaccine.


Ending preventable child deaths from pneumonia and diarrhoea by 2025

The integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD)The integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD)

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 and Control of Pneumonia and Diarrhoea (GAPPD) proposes a cohesive approach to ending preventable pneumonia and diarrhoea deaths. It brings together critical services and interventions to create healthy environments, promotes practices known to protect children from disease and ensures that every child has access to proven and appropriate preventive and treatment measures. The goal is ambitious but achievable: to end preventable childhood deaths due to pneumonia and diarrhoea by 2025.

Downloads
Ending preventable child deaths from pneumonia and diarrhoea by 2025: The integrated Global Action Plan for Pneumonia and Diarrhoea pdf, 780kb
Executive summary - English pdf, 770kb - Executive summary - French pdf, 870kb

Related publications
New plan to address pneumonia and diarrhoea could save 2 million children a year WHO/UNICEF news release
More documents on pneumonia - Pneumonia fact sheet
More documents on diarrhoea - Diarrhoeal disease fact sheet
The Lancet Series on Childhood Pneumonia and Diarrhoea



Largest ever diarrhea study highlights solutions

Findings published in The Lancet can guide prevention, treatment and research on diarrheal diseases, which claim the lives of 800,000 children annually

15 MAY 2013 — WHO - A new study published in The Lancet has pinpointed the primary causes and impact of diarrheal diseases—a leading cause of deaths among children globally—and has revealed new opportunities for intervention. The Global Enteric Multicenter Study (GEMS) is the largest study ever conducted on diarrheal diseases in developing countries, enrolling more than 20,000 children from seven sites across Asia and Africa.

GEMS, coordinated by the University of Maryland School of Medicine’s Center for Vaccine Development, confirmed rotavirus – for which a vaccine already exists – as the leading cause of diarrheal diseases among infants and identified other top causes for which additional research is urgently needed. GEMS found that approximately one in five children under the age of two suffer from moderate-to-severe diarrhea (MSD) each year, which increased children’s risk of death 8.5-fold and led to stunted growth over a two-month follow-up period.

Related links and documents

Global Enteric Multicenter Study (GEMS): Article in The Lancet - Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study - GEMS factsheet - GEMS website More information on ending preventable child deaths from diarrhoea
Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD)
PMNCH Knowledge Summary #25: Integrating immunization and other services for women and children
UNICEF report on pneumonia and diarrhoea


Childhood Pneumonia and Diarrhoea

Childhood Pneumonia and Diarrhoea - 2 Diseases, Many Solutions; 1 Global Action PlanExecutive summary - Published April 12, 2013 - Click here, for a comprehensive suite of resources and materials

The Lancet Series on Childhood Pneumonia and Diarrhoea, led by Aga Khan University, Pakistan, provides evidence for integrated control efforts for childhood pneumonia and diarrhoea. The first paper assesses the global burden of these two illnesses, comparing and contrasting them, and includes new estimates of severe disease and updated mortality estimates for 2011.

Findings from the second paper show that a set of highly cost-effective interventions can prevent most diarrhoea deaths and nearly two thirds of pneumonia deaths by 2025, if delivered at scale. Furthermore, the paper estimates what the cost of scale up will be.

The third paper presents the results of consultations with several hundred frontline workers in high-burden countries and explores the barriers and enablers they face in dealing with these two diseases and potential ways forward.

The final paper represents a call to action and discusses the global and country-level remedies needed to eliminate preventable deaths from these illnesses by 2025.

Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD), a new global plan from UNICEF and WHO, represents the first-ever simultaneous effort to protect children from pneumonia and diarrhoea, the two leading killer diseases of children less than five years old.

Mind the GAPPD — A Pivotal New Resource Offers Global and Local Strategies to Overcome Leading Child Killers
11 April 2013 - This week, we celebrate integration. Though it is intrinsically at the heart of what we and our partners do in addressing myriad global health challenges through thoughtful, efficient strategies, today integration is particularly at the fore. For the very first time, there is a global plan to simultaneously take on the two diseases killing more than 2 million young children each year: pneumonia and diarrhea.

Comments

Continuing the child survival revival
Richard Horton, Udani Samarasekera
Full Text | PDF

Integrated action for the prevention and control of pneumonia and diarrhoea
Margaret Chan, Anthony Lake
Full Text | PDF

Playing our part to save children's lives
Jakaya Kikwete, Kevin Jenkins, Jasmine Whitbread
Full Text | PDF
Series Papers
Global burden of childhood diarrhoea and pneumonia
Christa L Fischer Walker, Igor Rudan, Li Liu, Harish Nair, Evropi Theodoratou, Zulfiqar A Bhutta, Katherine L O'Brien, Harry Campbell, Robert E Black
Full Text | PDF

Interventions to address deaths from childhood diarrhoea and pneumonia equitably: what works and at what cost?
Zulfiqar A Bhutta, Jai K Das, Neff Walker, Arjumand Rizvi, Harry Campbell, Igor Rudan, Robert E Black, for The Lancet Diarrhoea and Pneumonia Interventions Study Group
Full Text | PDF

Bottlenecks, barriers, and solutions: results from multi-country consultations focused on reduction of childhood diarrhoea and pneumonia deaths
Christopher J Gill, Mark Young, Kate Schroder, Liliana Carvajal-Velez, Marion McNabb, Samira Aboubaker, Shamim Qazi, Zulfiqar A Bhutta
Full Text | PDF

Ending of preventable deaths from pneumonia and diarrhoea: an achievable goal
Mickey Chopra, Elizabeth Mason, John Borrazzo, Harry Campbell, Igor Rudan, Li Liu, Robert E Black, Zulfiqar A Bhutta
Full Text | PDF

Diarrhoea causes Dehydration

Children are more likely than adults to die from diarrhoea because they become dehydrated more quickly.

Children are more likely than adults to die from diarrhoea because they become dehydrated more quickly.
Diarrhoea is also a major cause of child malnutrition.

1.35 million people in developing countries, most of them children, die every year from diarrhoeal diseases associated with lack of access to safe drinking water, inadequate sanitation, poor hygiene and overcrowding. 90% are children under 5, mostly in developing countries. Undernutrition is the underlying cause of a substantial proportion of all child deaths.

Infants who are fed only breastmilk during the first 6 months seldom get diarrhoea. At six months, in addition to breastmilk, complementary foods with increased feeding frequency and changes in food consistency, quantity, and diversity as the child ages. Thousands of deaths could be averted through a combined prevention and treatment strategy — interventions such as improved mother and child nutrition, optimal breastfeeding practices; Oral Rehydration Therapy [ORT]; new low-osmolarity formulations of ORS; incorporating rotavirus vaccines; zinc supplementation during diarrhoea episodes; immunizing all children against measles; appropriate drug therapy; increased access to safe clean water and sanitation facilities and improved personal and domestic hygiene, including keeping food and water clean and washing hands before touching food. Families and communities are working together, with support from governments, states, corporations and non-governmental organizations, to prevent the conditions that cause diarrhoea and thereby rapidly reducing child mortality.


Causes of Child Deaths in Low-Income Countries: Diarrhoea 18%


Causes of child deaths in low-income countries
Source: WHO, World Health Statistics 2011

The Challenge




ORS is available in less than half of pharmacies and kiosks in African countries and zinc is not available at all in many places.



ORS - Oral Rehydration Salts : The most effective, least expensive way to manage diarrhoeal dehydration.

"The discovery that sodium transport and glucose transport are coupled in the small intestine so that glucose accelerates absorption of solute and water (is) potentially the most important medical advance this century."

The Lancet
British Scientific Journal
5th August, 1978


The Solution: ORS - a special drink for diarrhoea

Low Osmolarity - Oral Rehydration Salts (ORS) package What is ORS? ORS (oral rehydration salts) is a special combination of dry salts that is mixed with safe water. It can help replace the fluids lost due to diarrhoea.
When should ORS be used? When a child has three or more loose stools in a day, begin to give ORS. In addition, for 10–14 days, give children over 6 months of age 20 milligrams of zinc per day (tablet or syrup); give children under 6 months of age 10 milligrams per day (tablet or syrup).
Where can ORS be obtained?In most countries, ORS packets are available from health centres, pharmacies, markets and shops.
How is the ORS drink prepared?
  1. Put the contents of the ORS packet in a clean container. Check the packet for directions and add the correct amount of clean water. Too little water could make the diarrhoea worse.
  2. Add water only. Do not add ORS to milk, soup, fruit juice or soft drinks. Do not add sugar.
  3. Stir well, and feed it to the child from a clean cup. Do not use a bottle.
How much ORS drink to give?

Encourage the child to drink as much as possible.

A child under the age of 2 years needs at least 1/4 to 1/2 of a large (250-millilitre) cup of the ORS drink after each watery stool.

A child aged 2 years or older needs at least 1/2 to 1 whole large (250-millilitre) cup of the ORS drink after each watery stool.

What if ORS is not available?

Give the child a drink made with 6 level teaspoons of sugar and 1/2 level teaspoon of salt dissolved in 1 litre of clean water.

Be very careful to mix the correct amounts. Too much sugar can make the diarrhoea worse. Too much salt can be extremely harmful to the child.

Making the mixture a little too diluted (with more than 1 litre of clean water) is not harmful.


Homemade Oral Rehydration Solution Recipe

How to prepare an ORS solution at home

How to prepare One (1) Litre Oral Rehydration Solution [ORS] using Salt, Sugar and Water at Home


Place 6 level teaspoons of sugar and
a half level teaspoon of salt
into one litre of clean drinking water (or boiled water and then cooled)
- 1 litre = 5 cupfuls (each cup about 200 ml.)

Feed with a spoon


Be very careful to mix the correct amounts, as too much sugar can make the diarrhoea worse, and too much salt can be extremely harmful to the child. If the mixture is made a little too diluted no harm can be done and there is very little loss of effectiveness.

Encourage the child to drink as much as possible.

A child under the age of two needs at least a quarter to a half of a large cup of the ORS drink after each watery stool.

A child aged two or older needs at least a half to a whole large cup of the ORS drink after each watery stool.

Diarrhoea usually stops in three or four days. The real danger is the loss of liquid and nutrients from the child's body, which can cause dehydration and malnutrition.


Clinical Evaluation of Ultrasonic Hydration Monitor for Infants

Clinical Evaluation of Ultrasonic Hydration Monitor for InfantsStudy of Ultrasonic Hydration Monitor for Neonatology and Pediatric Children and Infants and/or Children up to Age 3 Years Old With Diarrhea

Study will verify ability of infant Hydration Monitor (IHM) to assess changes of hydration status in newborns and infants by means of ultrasound velocity measurements through muscle tissues. Changes of tissue hydration will be followed during first days of life in newborns and in acute diarrhea in small children during re-hydration therapy. Weighting and clinical dehydration symptoms will be used as controls.

Handheld device to diagnose newborn dehydration

Noune Sarvazyan and her team at Artann Laboratories in the U.S. are developing a hand-held ultrasonic device to measure water content in the soft tissue of newborns and diagnose dehydration, one of the leading causes of infant morbidity and mortality in the developing world.


Oral Rehydration Salts


You Don't Know $h!t About $h!t

August 09, 2012 - Despite the fact that people in the world do it every day, most of us probably don't know $h!t when it comes to the real facts about going. Likely, you walk into your bathroom in the morning sit down on a pristine porcelain bowl, do your business, and then flush away all the icky evidence with the easy push of a button or press of a lever. You, however, are the lucky ones. .... more


The Extraordinary Healing Power of Mom

Do you remember how your mom took care of you when you got sick? Moms everywhere want to take care of their kids. Diarrhea can be deadly, but mothers have hope when they have access to simple solutions. Proven, affordable tools should be at-hand for every mom, such as safe water and sanitation, oral rehydration therapy (ORT), zinc, nutrition, breastfeeding, and rotavirus vaccines.

"Even though we have the knowledge and solutions in hand to defeat diarrheal disease, the issue can be a difficult, even taboo subject to discuss. That’s why we need to break the barriers and increase awareness."

Integrated prevention and treatment solutions: child health, water and sanitation, nutrition, vaccines, zinc, and rehydration. Help us spread the word about these solutions so no child has to die from diarrhea.


The biggest scandal in global health today: Why are 2 million children dying from pneumonia and diarrhea every year?

29 October 2012 – If you don’t work in global health you might be surprised to learn that fighting the leading killers of children has not been a global priority. You might also be surprised to learn exactly what the leading killers of children under 5 are – two diseases, pneumonia and diarrhea. These two kill more children under 5 than AIDS, malaria and measles combined. They cause 2 million children to die every year and account for a massive 30% of all under 5 deaths. And yet they attract less than 5% of global health funding.

To add insult to injury we have very cost effective vaccines, antibiotics and other treatments like oral rehydration salts and zinc that can prevent and treat the leading causes of pneumonia and diarrhea. If we made them widely available, pneumonia and diarrhea would kill a fraction of the children that they do now. Vaccines alone have the power to prevent almost 1 million child deaths from pneumonia and diarrhea every year. When you add in antibiotics, oral rehydration salts, zinc and vitamin A supplements – each of which cost cents per dose – you can probably double that figure and wipe out almost all deaths.


Pneumonia and diarrhoea: Tackling the deadliest diseases for the world’s poorest children

Pneumonia and diarrhoea: Tackling the deadliest diseases for the world’s poorest children8 June 2012 – Preventing and treating pneumonia and diarrhoea – the two leading causes of death among children under five – can help save the lives of more than two million children, according to a report released today by the United Nations Children’s Fund (UNICEF).

“We know what works against pneumonia and diarrhoea – the two illnesses that hit the poorest hardest,” UNICEF’s Executive Director, Anthony Lake, said in a news release. “Scaling up simple interventions could overcome two of the biggest obstacles to increasing child survival, help give every child a fair chance to grow and thrive.”

Pneumonia and diarrhoea account for nearly one-third of the deaths among children under five globally – or more than 2 million lives each year. Nearly 90 per cent of deaths from pneumonia and diarrhoea occur in sub-Saharan Africa and South Asia.

The prevention and treatments for both diseases often overlap, and include such basic steps as: increasing vaccine coverage; encouraging breastfeeding and hand-washing with soap; expanding access to safe drinking water and sanitation; and disseminating oral rehydration salts to children with diarrhoea and antibiotics to children with bacterial pneumonia. Download pdf report

Towards ending preventable child deaths

Margaret Chan, Director-General of WHO and Anthony Lake, Executive Director of UNICEF "'We, as the leaders of WHO and UNICEF, are personally committed to the achievement of MDG 4 and new targets introduced through A Call to Action and A Promise Renewed. The two agencies will work in an even closer collaboration to support countries to achieve universal coverage of effective interventions - and effectively put an end to preventable child deaths."

Thanks in large part to the increased attention to maternal and child survival brought about by the Millennium Development Goals (MDGs), the world has made substantial progress in reducing child mortality over the past two decades. The number of deaths among children younger than 5 years has declined from more than 12 million in 1990 to 7·6 million in 2010. The mortality rate in children under 5 years has dropped from 88 deaths per 1000 livebirths in 1990 to 57 in 2010—a 35% reduction. The rate of decline in the under 5 mortality rate has accelerated from 1·9% a year from 1990 to 2000 to 2·5% a year from 2000 to 2010. The rate of reduction has doubled in sub-Saharan Africa. These gains underline the importance of having clearly defined targets, especially when they are combined with mechanisms for monitoring progress, ensuring equity, and promoting accountability.

Researchers Outline Plan to End Preventable Child Deaths in a Generation
From Johns Hopkins Bloomberg School of Public Health
Preventable childhood deaths caused by illnesses such as pneumonia and diarrhea can be nearly eliminated in 10 years according to researchers from the Johns Hopkins Bloomberg School of Public Health and the National Institutes of Health. In a new commentary featured in the June issue of the Journal of the American Medical Association, researchers outline a strategy and benchmarks for curbing childhood preventable deaths and recommend a new common vision for a global commitment to end all preventable child deaths. Read more.

Declaration on Scaling up Treatment for Diarrhea and Pneumonia - 2 page .pdf
PATH joined the US Agency for International Development, the Clinton Health Access Initiative, the Micronutrient Initiative, and others in raising a collective voice to call for investments to scale-up the use of proven tools, particularly oral rehydration solution, zinc, and amoxicillin with the Declaration on Scaling up Treatment for Diarrhea and Pneumonia. The Declaration represents an unprecedented commitment to the leading killers of children.


NEW - Where There is No Doctor: Belly Pain, Diarrhea, and Worms

NEW Where There Is No DoctorContent from the Advance Chapters of the NEW Where There Is No Doctor Everyone gets pain in the belly, nausea, vomiting, constipation, or diarrhea at one time or another. Most belly problems make you feel bad but are not dangerous. If pain or nausea is not severe, wait a few days and see if it gets better. It usually will.

Belly problems can be caused by many things. For example, someone may have a belly ache because of a cold or flu, because she ate bad food, or because she is worried about her children. Every cause requires a different kind of help. (Giving tablets for pain will do nothing to cure any of these causes!) But the cause of diarrhea, belly pain, or nausea may not be clear. As with all health problems, understanding the cause of the problem is the key to treating it. Begin by asking questions about the general problem, such as diarrhea, and then ask questions to help you learn more.

Chapter 15: Belly Pain, Diarrhea, and Worms
Pain in the Belly or Gut | Dehydration | Vomiting | Diarrhea | Worms | Other Problems with the Bowels | Itching or Painful Anus | Most Belly Problems Can Be Avoided | Medicines Print/download this chapter (PDF)


Did you Know?

bullet

Oral rehydration therapy and continued feeding is a life-saving treatment, which only 39 per cent of children with diarrhoea in developing countries receive. Limited data show little progress since 2000.

bullet

Zinc tablets are still largely unavailable in most developing countries, although their effectiveness in reducing the severity and duration of diarrhoea episodes is well known.

bullet Immunization against rotavirus, which results in an estimated 40 per cent of hospital admissions due to diarrhoea among children under five, is urgently needed worldwide, especially in Africa and Asia.
bullet

Safe water, adequate sanitation and proper hygiene are too often forgotten foundations of good health. Handwashing with soap alone could potentially reduce the number of diarrhoea cases by over 40 per cent.

bullet

Breastfeeding is critical to both the prevention and treatment of diarrhoea. Infants who are exclusively breastfed for the first six months of life and continue to be breastfed until two years of age and beyond develop fewer infections and have less severe illnesses, including diarrhoea.

bullet Vitamin A supplementation has been shown to significantly reduce child deaths, mostly from diarrhoea and measles.


Facts for Life Saves lives!

Facts for Life Home
What is Facts for Life?
Using Facts for Life

Timing Births
Safe Motherhood and Newborn Health
Child Development and Early Learning
Breastfeeding
Nutrition and Growth
Immunization
Diarrhoea
Coughs, Colds and More Serious Illnesses
Hygiene
Malaria
HIV
Child Protection
Injury Prevention
Emergencies: Preparedness and Response

PDF and Word versions
Resources

What every family and community has a right to know about DiarrhoeaDiarrhoea Facts for Life


Each year, around 9 million children die from preventable and treatable illnesses before reaching their fifth birthday. Many die during their first year of life. Countless more children live in precarious situations and face diminished futures. The handbook, Facts for Life, provides vital messages and information for mothers, fathers, other family members and caregivers and communities to use in changing behaviours and practices that can save and protect the lives of children and help them grow and develop to their full potential.

This version of Facts for Life builds on the three previous editions, which have been helping families and communities around the world since 1989. Newborn Health has been added to the Safe Motherhood chapter, giving attention to child survival from the first stage of life. A new chapter, Child Protection, has been included, focusing attention on the actions needed to ensure children grow up in protective environments.

Facts for Life is a trusted resource that is written in easy-to-understand language. It has been translated into 215 languages, with over 15 million copies of the previous editions in circulation worldwide. Users are encouraged to be innovative in finding ways to extend the reach of the Facts for Life messages to help families and communities realize the rights of children and women everywhere!


Zinc - The Next Revolution in Child Survival

Diarrhoeal disease is one of the greatest killers of children under the age of five. Using zinc supplements to treat diarrhoea, along with oral rehydration salts, not only helps children get better faster, it can even save their lives. Zinc - one of the more abundant elements on earth - has quickly emerged as an exciting new opportunity in the urgent quest to drastically reduce the number of global child deaths by the 2015 target for the Millennium Development Goals. When administered in conjunction with oral rehydration therapy (ORT), zinc has proven itself to be the most powerful tool to help children combat and recover from diarrhoeal disease. More than that, it has demonstrated important preventive power, helping children resist subsequent episodes of diarrhoea for up to three months, thereby reducing the number of episodes a child suffers each year and giving children more time to recuperate. In scientific terms, zinc supplementation in combination with ORT has been shown to reduce diarrhoeal incidence in children by an impressive 27%. Update: Some good news! The Lancet is reporting that diarrhoea deaths have dropped to around 1 million per year. This is promising news and hopefully these numbers will continue to decline as we treat more children who suffer from diarrhoea with zinc and ORS.


The Story of Cholera

The Global Health Media Project collaborated with award-winning animator Yoni Goodman to produce The Story of Cholera.

The Story of Cholera is an engaging, educational animation in which a young boy helps a health worker save his father and then guides his village in preventing cholera from spreading. By making the invisible cholera germs visible, this simple animated narrative brings to life the teaching points of cholera prevention.

The World Health Organization (WHO) reports an estimated 3–5 million cholera cases annually, resulting in 100,000–120,000 deaths worldwide. Cholera can kill quickly and, if not contained, will spread like wildfire. Yet, it is preventable and readily treatable.

Public education is an effective means to help contain epidemics. But at-risk populations are often poorly informed as to how cholera is spread and how to prevent transmission.

Watch and Download Videos and Flashcards:
EnglishFrenchGuerzéHaitian CreoleHaitian AndeyoHindiKrioMalinkéPoularSoussouSpanishSwahili


Translators Without Borders

Translators Without BordersThe work of Translators without Borders is of crucial importance for the success of humanitarian projects. Information available in the local language is much more effective than in a foreign language. This is true for engineering and construction projects (such as digging water wells), and agricultural projects (such as how to irrigate the land). But it is particularly important in healthcare. In many areas in the world people do not only die from diseases, but also from the fact that they do not have basic information about how to stay healthy and what to do to prevent disease.

If you are a translator and you are willing to donate your time and professional skills to Translators without Borders, you will directly support humanitarian projects. To join TWB, we ask you to fill in the translator application form.


Ghana takes on top two child killers simultaneously

Ghana takes on top two child killers simultaneouslyHistoric dual rollout of rotavirus and pneumococcal vaccines—a first for Africa

April 26, 2012—Today, Ghana made history. It became the first African country to simultaneously introduce vaccines against the primary causes of the two leading childhood killers worldwide—diarrhea and pneumonia. In Ghana, these killer diseases together account for approximately 20 percent of the country’s mortality in children under five years of age. The Expanded Program on Immunization Manager, Dr. K.O. Antwi-Agyei, decided that Ghana’s children could wait no longer for lifesaving vaccines and made the unprecedented decision to introduce both vaccines at once. "We could not introduce one vaccine and then wait—while our children were dying—to introduce the other. We have the systems and we have carefully planned the introduction process," said Dr. Anti-Agyei.

Preparations for the dual introduction were heroic and successful:
• Expansion of the cold chain to keep the vaccines cool in a tropic nation where electricity in rural areas is unreliable.

• Completion of training programs for tens of thousands of healthcare workers.
• Far-reaching public awareness campaigns taken to outreach centers in rural villages.
• Reissuance of millions of upgraded child health immunization cards.

Ghana has identified rotavirus vaccines as an essential and lifesaving intervention in its comprehensive diarrhea control strategy, thereby facilitating achievement of Millennium Development Goal 4—reduction of child mortality.


Defeat Diarrhoeal Diseases

defeatdd.org - controlling diarrheal disease

Despite substantial gains with effective interventions in the 1980s and 1990s, severe dehydration due to diarrhea continues to threaten too many children’s lives, particularly in the developing world. Simple, available, and proven tools promise dramatic reductions in diarrhea-related illness and deaths worldwide. In addition to established interventions that include oral rehydration therapy, exclusive breastfeeding, and improved hygiene, new tools like zinc and vaccines bring new opportunities to re-invigorate interest and catalyze investments in diarrheal disease control. [more]


Diarrhea: The Great Zinc Breakthrough

Diarrhea: The Great Zinc Breakthrough - 17 August, 2009

Can One Pill Tame the Illness
No One Wants to Talk About?

17 August, 2009 - It is hard to grasp the impact diarrhea has on people's lives across Africa and Asia. The disease kills more children than either malaria or AIDS, stunts growth, and forces millions — adults and children alike — to spend weeks at a time off work or school, which hits both a country's economy and its citizens' chances of a better future.

Taming a Devastating Illness with a Simple Pill See pictures of of how zinc is saving lives in Mali.
Zinc tablets help African communities fight diarrhea, a scourge that claims the lives of an astonishing 1.6 million children every year

Healing: The Unexpected Properties of Zinc

Scaling up oral rehydration salts and zinc for the treatment of diarrhoea

Scaling up the provision of zinc and ORS could rapidly reduce child mortality for four reasons.

Firstly, although it has been almost eight years since the World Health Organization recommended combination treatment with zinc and ORS, few countries have implemented basic interventions to increase the currently low use of adjunctive zinc. Such interventions would include marketing zinc to caregivers and distributing it in large volumes through both public and private facilities. Even limited additional investment in such interventions could have a large effect.

Secondly, children with diarrhoea can be reached and given appropriate treatment easily. Most children currently obtain some form of treatment for diarrhoea, but most of them receive inappropriate treatments such as antibiotics and antidiarrhoeal agents. Merely switching the treatments children receive, which is less challenging than trying to change caregivers' treatment seeking behaviour, could therefore drive substantial increases in ORS and zinc coverage.

Thirdly, and in contrast to treatments for malaria or pneumonia, effective treatment of diarrhoea does not need to be carefully targeted to selected children in whom a definitive diagnosis is made. A strategy of "flooding the market" with ORS and zinc­ distributing them through all outlets where caregivers seek treatment ­could be pursued safely, with no threat of drug resistance, for example.

Lastly, a full course of zinc and ORS treatment costs less than $0.50 (£0.3; €0.38), and the marketing, training, and distribution necessary to drive product uptake could also be implemented at comparatively modest cost. Moreover, public funding for procurement of zinc and ORS in many countries would be further moderated by the fact that most treatment for diarrhoea is delivered through the private sector and paid for out of pocket. >> more


A Simple Solution

TIME Europe Magazine Oct. 16, 2006 | Vol. 168, No. 17
TIME Europe
16 October 2006
pp40-47


Download pdf 2.16Mb

Diarrhea kills more young children around the world than malaria, AIDS and TB combined. Yet a simple and inexpensive treatment can prevent many of those deaths. Why isn't it more widely used?

A Simple Solution
In the West, it's an inconvenience, but, in the developing world, it can be a death sentence. It kills millions of children every year, yet the treatment is a simple mixture of salt, sugar and water. So why isn't more being done to fight diarrhea?

Surviving Diarrhea
Most deaths from diarrhea can be prevented by giving the victim oral rehydration. A guide to how it works

Authors: Gerlin, Andrea, Number of pages: 8, Publication date: 2006, Languages: English Overview

In this article, published in Time Magazine in October 2006, the author Andrea Gerlin, investigates the reasons why diarrhoea still kills 1.9 million children every year, and why Oral Rehydration Solution is not more widely used throughout the world.


Simple Interventions and Solutions

Why is Dehydration so dangerous?Dehydration

Prevent and Treat | Treatment Plans
Dehydration caused by diarrhoea is one of the biggest single killers of children in the modern world and diarrhoea itself is one of the major causes of nutritional loss and poor growth. [more]

Why is Rehydration so important?Rehydration

"The discovery that sodium transport and glucose transport are coupled in the small intestine so that glucose accelerates absorption of solute and water (is) potentially the most important medical advance this century." The Lancet - British Scientific Journal - 5th August, 1978 [more]


Oral Rehydration SolutionsOral Rehydration Solutions

Home Made | Packaged
Most often, diarrhoea kills a child by dehydration, which means that too much liquid has been drained out of the child's body. To replace the liquid being lost it is essential to give the child extra drinks as soon as diarrhoea starts. Oral Rehydration Therapy (ORT) is the cheap, simple and effective way to treat dehydration caused by diarrhoea. [more]

Breastfeeding the first 6 months of lifeBreastfeeding

Facts | Frequently Asked Questions | HIV
During the first 6 months of life, infants should be exclusively breastfed. This means that the healthy baby should receive breastmilk and no other fluids, such as water, teas, juice, cereal drinks, animal milk or formula.

Exclusively breastfed babies are much less likely to get diarrhoea or to die from it than are babies who are not breastfed or are partially breastfed. [more]


Oral Rehydration SolutionsLow-Osmolarity ORS

Q & A | Technical FAQs
Oral Rehydration Salts (ORS) has been the cornerstone of diarrheal disease control since 1970s. Recently, the ORS formulation was revised by reducing the sodium and glucose content. This new, low-osmolarity ORS, improves the efficacy of ORS, reduces the need for unscheduled intravenous infusions, lowers stool volume, and causes less vomiting compared with standard ORS. [more]

Zinc Supplementation - Treatment of diarrhoea is now more effectiveZinc Supplementation

ORS and Zinc: Treatment of diarrhoea is now more effective
Recent studies suggest that a 10- to 14-day therapy of zinc treatment can considerably reduce the duration and severity of diarrhoeal episodes, decrease stool output, and lessen the need for hospitalization. Zinc may also prevent future diarrhoea episodes for up to three months. [more]


Rotavirus Disease & VaccinesRotavirus Disease & Vaccines

Key Facts | Promise and Potential
Worldwide, almost every child will have at least one rotavirus infection before he or she is five years old. The virus is so contagious and resilient that providing clean water and promoting proper hygiene do not significantly reduce incidence, which is nearly the same in industrialized and developing countries. Additionally, because rotavirus usually causes profuse vomiting, ORS/ORT is difficult to administer. [more]

Hygiene, Hand-washing and Clean WaterHygiene, Hand-washing and Clean Water

Providing clean water for drinking and food preparation, teaching children and adults to wash their hands properly are some of the most important things governments and families can do to protect health. These proven interventions have already made a world of difference for millions and millions of people. [more]

Why is Breastfeeding So Important?

Why is breastfeeding so important?Breastfeeding provides the perfect nutrition for your baby and provides many health benefits for both mother and baby.

Initiating breast feeding within the first hour and exclusive breastfeeding can prevent under two mortality.
Breastfeeding: Exclusive breastfeeding
Colostrum - Gift of a protective cover from the mother
We believe all mothers know how to feed their child. But do they?
Myths and facts about breast milk
Complimentary feeding
Role of media in promoting proper young child feeding: Media should focus on and promote measures that are required to be taken urgently to ensure the survival of children Why Is Breastfeeding So Important?Download .pdf 17.5 mb.


Key Resources

Health Education To Villages
hetv.org

Health Education to Villages « website

HETV works within the existing health framework of developing countries to establish and promote health educational programs that will provide rapid and long-term capacity-building to improve health and quality of life, and will give mothers and communities more control over their health status. Partnered with national and state governments, we work to assist in educating mothers and children, teachers and students, doctors and village health workers, and a variety of community leaders, in the targeted areas of health, water, hygiene, and sanitation. [more]


Initiation of Breastfeeding by Breast Crawl
breastcrawl.org

Initiation of Breastfeeding by Breast Crawl « website

Video | 10 Steps to Successful Breastfeeding | Scientific Overview | Recommendations & Vision | Reviews
UNICEF, WHO and WABA along with the scientific community strongly recommend initiating breastfeeding within half an hour of birth. Evidence shows that early initiation can prevent 22% of all deaths among babies below one month in developing countries. Every newborn, when placed on the mother’s abdomen, has ability to find its mother’s breast all on its own and to decide when to take the first breastfeed. This is known as the ‘Breast Crawl’. [more]


Mother, Infant and Young Child Nutrition & Malnutrition
motherchildnutrition.org

Mother, Infant and Young Child Nutrition & Malnutrition « website

The fight against persistent underweight, stunting and wasting among children in developing countries is based on appropriate maternal, infant and young child feeding practices including micronutrient deficiencies prevention and control. However, wasted children are those at immediate risk of dying and will need timely detection and correct management for their survival.

More than half of all child deaths are associated with malnutrition, which weakens the body's resistance to illness. Poor diet, frequent illness, and inadequate or inattentive care of young children can lead to malnutrition. Of the 6.6 million deaths among children aged 28 days to five years: 1.7 million (26%) are caused by diarrhoea. 1 million (61%) of these deaths are due to the presence of undernutrition.

What is needed: Enough food and the right kinds of food, Nutritional needs of girls and women, Nutritional needs of young children, Protecting children from infections, Quality care when children fall ill, prevention of Micronutrient deficiencies. [more]


Diarrhoea: Why children are still dying and what can be done
7pointplan.org

Diarrhoea: Why children are still dying and what can be done « website

UNICEF/WHO Report - 4 October, 2009 - Download pdf 3 Mb
Diarrhoea is the second leading cause of death among children under five globally. Nearly one in five child deaths – about 1.5 million each year – is due to diarrhoea. It kills more young children than AIDS, malaria and measles combined. Today, only 39 per cent of children with diarrhoea in developing countries receive the recommended treatment, and limited trend data suggest that there has been little progress since 2000.

The objective of this WHO/UNICEF report is to focus attention on the prevention and management of diarrhoeal diseases as central to improving child survival. It examines the latest available information on the burden and distribution of childhood diarrhoea. It also analyses how well countries are doing in making available key interventions proven to reduce its toll. Most importantly, it lays out a new strategy for diarrhoea control, one that is based on interventions drawn from different sectors that have demonstrated potential to save children's lives. It sets out a 7-point plan that includes a treatment package to reduce childhood diarrhoea deaths, as well as a prevention package to make a lasting reduction in the diarrhoea burden in the medium to long term. [more]


Ten Steps to Successful Breastfeeding
tensteps.org

Ten Steps to Successful Breastfeeding « website + video series

Babies who are breastfed are generally healthier and achieve optimal growth and development compared to those who are fed formula milk. If the vast majority of babies were exclusively fed breastmilk in their first six months of life – meaning only breastmilk and no other liquids or solids, not even water – it is estimated that the lives of at least 1.2 million children would be saved every year. If children continue to be breastfed up to two years and beyond, the health and development of millions of children would be greatly improved. [more]

Ten Steps to Successful Breastfeeding


Health Professionals

Health worker and professional informationThe scientific rationale for ORT, and for continued feeding during diarrhoea, has been established beyond doubt. The challenge now is to place that knowledge in the hands of parents so that they themselves can protect their children against the dehydration and malnutrition caused by childhood's most common disease.


Slide Shows, Facts, FAQs

A Simple Solution - set of 198 slides

A Simple Solution
A Programme to curb the effects of diarrhoea / diarrhea in infants and young children
198 slides

Diarrhoea / Diarrhea Facts for Life by UNICEF, WHO, UNESCO, UNFPA, UNDP, UNAIDS, WFP and the World Bank.

Facts for Life
The handbook, Facts for Life, provides vital messages and information for mothers, fathers, other family members and caregivers and communities to use in changing behaviours and practices that can save and protect the lives of children and help them grow and develop to their full potential.

Acute Diarrhoeal Diseases - set of 36 slides

Acute Diarrhoeal Diseases
Clinical Features and Management
36 slides

Water Facts

Water Facts
Waterborne diseases (the consequence of a combination of lack of clean water supply and inadequate sanitation) cost the Indian economy 73 million working days a year.
Water Facts | Water | Children | Disease | Economics | Sanitation | Women
One Billion Affected | The Women's Crisis

Facts about children, diarrhoea / diarrhea, water, ...

Facts About Women, Children, Diarrhoea, Water, Nutrition, Hunger, Hygiene, Sanitation...

A Kind of Living - set of 78 slides

A Kind of Living
Life of a young boy, Babu, in a city
78 slides


Frequently Asked Questions

Frequently Asked Questions
Some of the more commonly asked questions about Diarrhoea, Dehydration, Oral Rehydration Salts - Home Prepared and Packets, and Oral Rehydration Therapy.


Inside rehydrate.org

Diarrhoea

bullet Diarrhoea: Why children are still dying and what can be done
bullet Good foods during Diarrhoea

Dehydration

bullet The symptoms of dehydration
bullet Dehydration Treatment Plans
bullet What to Do if Dehydration Occurs

Rehydration

bullet 10 Things You Should Know About Rehydrating a Child
bullet Rehydration Challenges
bullet Facts Sheet: Oral Rehydration Therapy & Oral Rehydration Solution

Oral Rehydration Therapy

bullet What is Oral Rehydration Therapy (ORT)
bullet How Oral Rehydration Therapy Works
bullet Management of Diarrhoea and Use of ORT

Oral Rehydration Salts

bullet A Simple Solution
bullet Homemade Solutions
bullet Packaged Solutions

Low Osmolarity ORS

bullet Questions & Answers
bullet Frequently Asked Technical Questions
bullet Expert Consultation on ORS Formulation

Nutrition

bullet Mother, Infant and Young Child Nutrition & Malnutrition
bullet Infant and Young Child Nutrition (IYCN) Project
bullet WHO recommendations on infant feeding in the context of HIV

Breastfeeding

bullet Facts for Feeding
bullet Initiation of Breastfeeding by Breast Crawl
bullet Breastfeeding: Frequently Asked Questions

Rotavirus

bullet Key Facts About Rotavirus Disease and Vaccines
bullet Rotavirus Updates
bullet PATH Rotavirus Vaccine Program

Zinc & Other Micronutrients

bullet The Great Zinc Breakthrough
bullet Fact Sheet: Zinc Treatment for Diarrhea
bullet ZINC Publications and Reference Materials

Hygiene & Handwashing

bullet The Handwashing Handbook
bullet Combating waterborne disease at the household level
bullet Effect of washing hands with soap on diarrhoea risk in the community

Clean Water

bullet Water, Sanitation and Hygiene: At a glance
bullet Drinking water quality
bullet Water, Sanitation, Hygiene and Health News





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1 July, 2014

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