Diarrhoea hits child population severely in region

Rawalpindi : After the setting in of monsoon, the majority of the child patients reaching outpatient departments and emergency departments of the three teaching hospitals in town are suffering from diarrhoea with dehydration while the number of cases with typhoid fever and hepatitis A is also registering a sharp rising trend.

Data collected by ‘The News’ on Saturday has revealed that not less than 25 per cent of the total child patients and infants reaching paediatrics departments of the allied hospitals are with complaints of diarrhoeal disease including vomiting and loose motion.

t is important that diarrhoeal disease, the third leading cause of death in children under five years of age, is an infection in the intestinal tract caused by a variety of bacterial, viral or parasitic organisms.

Every year, with the setting in of hot and humid weather, a greater number of child and infant patients with diarrhoea, enteric fever and hepatitis A along with malaria are reported at the paediatrics departments of the teaching hospitals including Benazir Bhutto Hospital, Holy Family Hospital and Rawalpindi Teaching Hospital.

Diarrhoea, typhoid fever and hepatitis A, all the three infections are caused by the use of contaminated and unsafe drinking water. All three are water borne diseases and preventable. If clean safe preferably boiled water (rolling boil for one minute) is given to the children, they would be protected from these diseases, said Dean of Paediatrics at Rawalpindi Medical University Dr. Rai Muhammad Asghar while talking to ‘The News’ on Saturday.

Studies reveal that diarrhoea is mainly caused by the use of contaminated food, unsafe drinking water or from person to person as a result of poor hygiene.

We should teach the children to wash hands before eating and after coming from the toilet with soap.

They should avoid taking food and drinks from street vendors. Common organisms causing diarrhoea in children are Rota virus and E. coli, both cause dehydrating diarrhoea, explained Dr. Rai.

He added antibiotics are not recommended as this diarrhoea is self limiting but we have to keep an eye on dehydration. As the diarrhoea starts, mothers should start giving ORS to prevent dehydration. Mortality in acute diarrhoea is because of dehydration and loss of electrolytes, he said.

He added that ORS to a child should be given by cup and spoon, one spoon full after every minute. Fifty to hundred ml of ORS should be given after every watery stool or vomiting if the child is less than two years of age. Once diarrhoea stops, mother should stop giving ORS otherwise there is a risk of Hypernatremia (increased blood sodium), he said.

He added that in severe dehydration, a child is unable to drink and gets abnormally drowsy. Therefore a child with severe dehydration must be admitted to a hospital and given intravenous fluids. During diarrhoea, feeding should be continued.

Banana, rice and yogurt should be given which are easily digestible. Banana will not only provide nutrition and calories but also potassium which is lost in watery stools, explained Dr. Rai.

He suggested that during the first six months of life, a child should be given exclusive breastfeeding which will not only protect from diarrhoea but from pneumonia and other infections.

Dr. Rai said Rotavirus vaccine is included in our EPI program. All EPI vaccines are freely available at all public sector hospitals and EPI centres and parents must ensure timely administration of these vaccines.

Typhoid (TCV Typhoid Conjugate Vaccine) is also included in the EPI program. TCV has high efficacy and 95 per cent seroconversion rate, the production of antibodies to protect against typhoid fever, said Dr. Rai.