Diarrhea and Dehydration
3. Diarrheal Illnesses
OBJECTIVES
- Describe the management of acute diarrhea.
- Identify the clinical indications for antibiotic therapy for diarrheal illness in an acute emergency setting.
- Identify the clinical features of dysentery, the most frequent causative pathogens, and the antibiotics that can be used to treat the infection.
- Use the Integrated Management of Childhood Illness (IMCI) guidelines in the treatment of children with diarrhea.
Definition of Diarrhea
Diarrhea is the passage of loose or watery stools at least 3 times in a 24 hour period. However, it is the consistency of the stools rather than the number that is most important. Acute diarrhea may be caused by different viruses, bacteria, and parasites. Rotavirus and Norwalk-like virus are the most common agents, causing up to 50% of acute diarrhea cases during the high-incidence seasons. It is most practical to base the treatment of diarrhea on the clinical type of the illness, which is easy to establish when a child is first examined. Usually there is no need for laboratory tests.
In disaster situations, due to overcrowded living conditions, lack of adequate clean water supply, and stool disposal, diarrhea is one of the most significant causes of morbidity and mortality, particularly among children. Early detection and treatment are therefore key elements in public health interventions, not only to manage individual cases but also to prevent transmission of the disease to the rest of the population. Effective hygiene measures markedly reduce the frequency of diarrheal diseases.
CASE 1:
In disaster situations, due to overcrowded living conditions, lack of adequate clean water supply, and stool disposal, diarrhea is one of the most significant causes of morbidity and mortality, particularly among children. Early detection and treatment are therefore key elements in public health interventions, not only to manage individual cases but also to prevent transmission of the disease to the rest of the population. Effective hygiene measures markedly reduce the frequency of diarrheal diseases.
- What is the most probable etiology of this infant’s illness?
- What treatment should be given?
- What measures should be taken to prevent recurrences?