Diarrhoeal disease is the second leading cause of death
in children under five (5yrs)years old.
Its kills around 1.8 million of which 90% are children
under 5 yrs each year
Causes 1.7 billion cases each year
Leading cause of malnutrition in children under 5
What is diarrhoea?
Diarrhoea is defined as the passage of three or more
loose or liquid stools per day (or more frequent
passage than is normal for the individual).
Frequent passing of formed stools is not diarrhoea, nor
is the passing of loose, "pasty" stools by breastfed
Clinical types of diarrhoea
acute watery diarrhoea – lasts several hours or
days, and includes cholera;
acute bloody diarrhoea – also called dysentery; and
persistent diarrhoea – lasts 14 days or longer.
Why does it kill mostly children?
It’s a matter of water loss – dehydration.
Losing 2% of the body’s water will make you feel sick.
Losing 10% of the body’s water may kill you
Since babies and small children cannot tell us how
they feel it’s important we go through the signs of
The most severe threat posed by diarrhoea is
During a diarrhoeal episode, water and electrolytes
(sodium, chloride, potassium and bicarbonate) are lost
through liquid stools, vomit, sweat, urine and
Dehydration occurs when these losses are not
The degree of dehydration is rated on a scale of
Sign of Dehydration
1. Early dehydration – no signs or symptoms.
2. Moderate dehydration:
restless or irritable behaviour
decreased skin elasticity
3. Severe dehydration:
shock, with diminished consciousness,
lack of urine output
cool, moist extremities
a rapid and feeble pulse
low or undetectable blood pressure
Sign of Dehydration Cont.
What causes diarrhoea?
A virus, such as rotavirus, winter vomiting disease
(Norwalk virus or norovirus), enterovirus, or a
A bacterium, such as E. coli, salmonella, shigella,
C.diff (clostridium), or cholera (Vibrio cholerae).
A parasite, such as those that cause giardiasis and
Other medical conditions
A number of non-infectious medical conditions may
cause diarrhoea, too. These include:
Inability to digest certain foods
Surgery to remove part of your intestine.
After – effects of surgery to remove the gallbladder.
Certain diseases of the endocrine (hormonal) system,
including thyroid disease, diabetes, adrenal disease, and
Inflammation in the intestinal tract, which can result
in chronic diarrhoea. If you have inflammatory bowel
disease (such as ulcerative colitis or Crohn’s
disease), you will have bouts of diarrhoea during flare-
ups of your disease.
Pouches of the intestinal wall in diverticular disease
can lead to diarrhoea, especially if they become
infected and inflamed (diverticulitis)
Other medical conditions Cont.
Source: Water contaminated with human faeces, for example, from
sewage, septic tanks and latrines, is of particular concern. Animal
faeces also contain microorganisms that can cause diarrhoea.
Diarrhoeal disease can also spread from person-to-person, aggravated
by poor personal hygiene.
Food is another major cause of diarrhoea when it is prepared or stored
in unhygienic conditions.
Water can contaminate food during irrigation.
Fish and seafood from polluted water may also contribute to the
Medications and other substances – antacids containing
magnesium, laxatives, diuretics, radiotherapy for prostate cancer or
cancers in the abdomen.
Symptoms of diarrhoea
Increased frequency of bowel movements
Loose, watery stools
Urgency (having to go right away)
Incontinence (leakage of stools)
Lower abdominal pain or cramping
Blood or flecks of mucus in the stool
Loss of appetite, weight loss
Symptoms of diarrhoea Cont.
Seek medical advice if:
Seek medical advice if you have diarrhoea for more than
three to four days
Blood in your stool
Dark-black stool that looks like tar (but tell your doctor if
you have been taking over-the-counter medications, which
also can make the stool look darker than usual)
Mucus passed with no stools
Recent travel abroad
Recent seafood consumption
Reason to believe that you have food poisoning
Family members who have similar illness
Seek medical advice if: Cont.
Prevention and treatment
access to safe drinking-water
use of improved sanitation
hand washing with soap
exclusive breastfeeding for the first six months of life
good personal and food hygiene
health education about how infections spread
Treatment of diarrhoea
Rehydration: with oral rehydration salts (ORS) solution.
ORS is a mixture of clean water, salt and sugar.
Zinc supplements: zinc supplements reduce the duration of
a diarrhoea episode by 25% and are associated with a 30%
reduction in stool volume.
Rehydration: with intravenous fluids in case of severe
dehydration or shock.
Consulting a health professional, in particular for
management of persistent diarrhoea or when there is blood
in stool or if there are signs of dehydration.