Title: Diarrhea in Children- A Major Global Killer (part 2)<br/>Author: Jon Mark Hirshon<br/><a href='http://umem.org/profiles/faculty/96/'>[Click to email author]</a><hr/><p>
        <strong>Introduction:</strong></p>
<p>
        As noted in the previous pearl (May 20, 2015), globally diarrheal diseases are the second leading cause of death for children under five- killing approximately 760,000 annually.  What can be done to prevent and treat diarrhea, especially among young children?</p>
<p>
         </p>
<p>
        <strong>Prevention of diarrheal illness:</strong></p>
<ul>
        <li>
                Improve access to safe drinking water</li>
        <li>
                Improve access to sanitary facilities (i.e.- toilets)
                <ul style="list-style-type:circle;">
                        <li>
                                Keep drinking water and sewage separate!</li>
                </ul>
        </li>
        <li>
                Good personal hygiene
                <ul style="list-style-type:circle;">
                        <li>
                                Hand washing with soap</li>
                </ul>
        </li>
        <li>
                Good food hygiene</li>
        <li>
                Breastfeeding during the first 6 months of life</li>
        <li>
                Improved health education for individuals and communities
                <ul style="list-style-type:circle;">
                        <li>
                                Especially about the spread of infectious diseases</li>
                </ul>
        </li>
        <li>
                Increased rotavirus vaccination</li>
</ul>
<p>
         </p>
<p>
        <strong>Treatment of diarrheal illness:</strong></p>
<ul>
        <li>
                Oral rehydration salts (ORS)
                <ul style="list-style-type:circle;">
                        <li>
                                Made from clean water, salt and sugar</li>
                        <li>
                                Cheap (a few cents per treatment)</li>
                        <li>
                                Absorbed in the small intestine</li>
                        <li>
                                Replaces water and electrolytes lost in the diarrheal stools</li>
                </ul>
        </li>
        <li>
                Zinc supplements
                <ul style="list-style-type:circle;">
                        <li>
                                Reduces duration and volume of stools</li>
                </ul>
        </li>
        <li>
                Intravenous rehydration for severe dehydration or shock</li>
        <li>
                Nutrient-rich food (including breast milk) as tolerated during an episode
                <ul style="list-style-type:circle;">
                        <li>
                                Generally- good nutrition and a nutritious diet to keep children healthy</li>
                </ul>
        </li>
        <li>
                Appropriate (and selective) use of antibiotics
                <ul style="list-style-type:circle;">
                        <li>
                                Not appropriate for most cases of diarrhea in young children</li>
                </ul>
        </li>
</ul>
<p>
         </p>
<p>
        <strong>Bottom Line</strong></p>
<p>
        Diarrheal diseases kill hundreds of thousands of children in developing countries each year.  Appropriate prevention measures (clean water, improved sanitation) can markedly decrease the burden of disease.  Appropriate treatment (ORS) can save lives for pennies.</p>
<fieldset><legend>References</legend>

                <p>
         </p>
<p>
        <a href="http://www.who.int/mediacentre/factsheets/fs330/en/">http://www.who.int/mediacentre/factsheets/fs330/en/</a></p>
<p>
        <a href="http://www.cdc.gov/healthywater/global/diarrhea-burden.html">http://www.cdc.gov/healthywater/global/diarrhea-burden.html</a></p>
<p>
        http://emedicine.medscape.com/article/906999-clinical#a0217</p>
</fieldset>