Child HealthResearch

Prevention of Diarrheal Diseases

Prevention of Diarrhoeal Disease

Human feces contain most kinds of bacteria responsible for infectious diarrhea. Proper disposal of feces combined with good personal hygiene (hand washing after defecation and before handling of food) and provision of potable drinking water in adequate quantity should eliminate most kinds of water-borne and water-related diarrheas.

Breastfeeding and weaning practice. The nearly universal practice, of breastfeeding prevalent in rural Bangladesh, should ensure good protection against infectious diarrhea. Encouragement to a mother for administering. colostrum containing antibodies to the newbOrn infants should be made a universal practice through education. The increasing practice of early weaning or not breastfeeding amongst the so-called “educated” well-to-do mothers living in the urban areas should be reversed through mass education. Breast milk alone is unable to ensure proper growth of infants after about six months of age when palatable and easily digestible freshly cooked food should be supplemented at frequent intervals. Complete weaning should not ordinarily take place before one year of age.

Water for drinking and domestic use. Drinking water:;should be free from fecal contamination and its quantity should be adequate to ensure clean body and clean hands. Tube wells or hand pumps are found near of within 100 Meters of nearly all the families in rural Bangladesh. It should he emphasized that drinking of tube well water will not be enough to prevent diarrhea unless it is combined with the use of good quality water for kitchen and for the preparation of food as well as for its cooking.

Personal hygiene. Compulsory washing or hands before handling food items and after defecation will ensure the protection of the family members against diarrhea attacks when combined with good sources of potable water.

Use of sanitary latrines. In the Bangladesh context. the cost of building a sanitary latrine is rather high. However, it is being promoted vigorously and is often supplied at subsidized cost at less than Taka 600 or US$ 5 each. Once a family is induced to become accustomed to the convenience of using a sanitary latrine. they will be prepared to spend considerable- ‘amount of their earnings to continue to use the facility. a poor family will get back its investment on a latrine through savings due to expenses incurred for treatment of diarrheal within a period of one or two years.

A vaccine against rotavirus. The It. S. Food and Drug Administration approved the world’s first vaccine against rotavirus, the leaOinL, cause: of childhood diarrhea. The experts predict that the vaccine, Rotashield, could save thousands of children every year, but the relatively high cost will limit its use in the developing countries. where it is most needed. For vaccination Oral doses will be required, taken at ages two, four and six months.

Immunization against measles. Attack of measles, besides malnutrition and respiratory diseases, causes profound depression of immunological reaction in a child who soon becomes highly susceptible to attacks from shigellosis. As a matter of fact epidemic of measles is soon followed by the epidemic of dysentery, both of which cause high rates of mortality. Therefore, providing immunization against measles at right age also protects against attacks of dysentery.

Epidemic Control of Diarrheal Disease

Epidemics or outbreaks of acute diarrhea due to a specific pathogen cause the sharp increase in morbidity and mortality. Such outbreak creates panic among the people and may cause the socio­political uproar in the country. So. it becomes necessary to take special measures to control an epidemic in the shortest possible Inne. These measures also form a part or the general program of prevention and control of diarrhoeal diseases.

In Bangladesh cholera, outbreaks are common, though shigella outbreaks were also reported to occur. However. the principles and general activities for control of epidemic of any diarrhoeal disease are similar. National Programme for Control of Diarrhoeal Diseases won control epidemics of diarrhoeal disease like cholera by ensuring the implementation of strategies .

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