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ACUTE CHILDHOOD DIARRHEA: A REVIEW OF RECENT ADVANCES IN THE STANDARD MANAGEMENT
ACUTE CHILDHOOD DIARRHEA: A REVIEW OF RECENT ADVANCES IN THE STANDARD MANAGEMENT
SEEMA ALAM RAJEEV KHANNA UZMA FIRDAUS
Pediatric Gastroenterology Section, Department of Pediatrics, JNMC, AMU, Aligarh
Corresponding Author Corresponding Author : Corresponding Author


Dr Seema Alam, Reader, Department of Pediatrics, JN Medical College, AMU, Aligarh, UP. Email seema_alam@hotmail.com

Diarrhea is one of the most common causes of morbidity and mortality in children all over the world especially in developing countries. The median global incidence of diarrhea was 5 and 2.6 episodes per child per year in infants (6-11months) and for all children between 0-4 years respectively 1 . Much higher rates are seen in children from low socioeconomic status. In India there has been an improvement in the situation from 6 diarrheal episodes per child per year in infants in 1984-85 to 2-3 episodes per child per year a decade later 1 . In 1980 it was estimated that 4.6 million children under 5 years age die annually due to diarrhea . Ten years later, the annual number of deaths attributable to diarrhea was estimated to be 3.3 millions which in 2000 was estimated to be 1.6- 2.5 million 1 . Median global mortality is highest among infants (8.5 per 1000 live births) while for children aged 1-4 years it was 4.6 deaths per 1000 live births 1 . Median global percentage of deaths due to diarrhea in 0-5 years is 21 % in the decade 1990-2000 1 . As evident from the developed countries effective interventions, including correct management (ORT, continued feeding and antibiotic in case of dysentery), promotion of exclusive breast-feeding, better weaning practices, improvement in socioeconomic and literacy status have the potential of reducing the diarrheal diseases. As is evident from Table 1 mortality rates have fallen substantially over the last few decades. In contrast incidence of diarrhea has remained stable, which is a worrying factor as multiple episodes have a harmful effect on physical growth and cognitive functions.

Table 1: Diarrheal estimates in children of developing countries
Author(s) (Publication Year) Period Deaths per Year (millions) Deaths per 1000 per Year Episodes per Child per Year Methods
Snyder & Merson (1982) 4 1954-79 4.6 13.6 2.2 Long. Cohorts and active surveillance
Bern et al.(1992) 2 1980-90 3.3 7.6 2.6 Long. Cohorts and active surveillance
Kosek et al (2003) 1 1990-2000 2.5 4.6 3.2 Data from surveys using WHO methods
 
 
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