An overview of the aetiologic agents of diarrhoea diseases in children: How far have we gone in management and control?

Abstract

Diarrhoea disease is the second leading cause of death amongst Nigerian children  (after malaria) with a prevalence rate in Nigeria of 18.8% which is one of the worst in sub-Sahara Africa. A major contributor to childhood morbidity and mortality, causes  4 million deaths each year in under-fives with each child experiencing about 5 episodes of diarrhoea yearly. We review diarrhoea diseases in children with focus on infectious diarrhoea with the aim of looking at the progress made so far in its management and control. Diarrhoea can be classified into acute and chronic;  secretory, osmotic, inflammatory or due to impaired motility;  infectious and non-infectious. In developing countries, infections are the most common causes of acute watery diarrhoea in  children, whereas chronic diarrhoea results from  non-infectious causes like inherited metabolic disorders, sensitivity to gluten or
neoplasm. Diagnosis includes a careful history from the patient, examination of stool sample and examination of faecal swab  samples where stool is not available. Diarrhoea in this age group is mostly of infectious origin and can be viral, bacterial, parasitic or fungi. Treatment in this environment is primarily supportive with oral or intravenous fluid and preventive measures include  domestic hygiene promotion, breast-feeding promotion, improved weaning practices, probiotic use, oral  rehydration therapy with additional L-glutamine, zinc supplementation and  vaccination against childhood infectious diseases like rotavirus, measles and cholera. An aluminmagnesium silicate, Smectite® has been found to be of potential benefit in the management of diarrhoea. Use of Rotavirus vaccines, probiotics and Smectite® is being advocated.