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Rural areas often face a lack of essential healthcare services.

Annual 443,832 Under-five Deaths from Diarrhoea Preventable – Experts

Deaths from diarrhoea, physicians say have been on the increase and insist that nobody, especially children should not succumb to the preventable tragedy.

They said despite being highly preventable and treatable, the illness persists as the third leading cause of mortality among children under five years old, claiming over 443,832 lives annually.

In the relentless battle to safeguard the well-being of our children, the physicians underscored the indispensable role of good hygiene practices as a fundamental defence against this pervasive killer.

Diarrhoea, characterised by frequent watery stools, dehydration, and sometimes vomiting, is often triggered by contaminated food or water, poor sanitation, and inadequate hygiene practices, experts said.

According to the World Health Organisation (WHO), diarrhoea is the passage of three or more loose or liquid stools per day, or more frequently than is normal for an individual.

The WHO said diarrhoea is the third leading cause of death in children one to 59 months of age, and which are both preventable and treatable.

The world health body stated that each year, diarrhoea kills around 443, 832 children under five and an additional 50, 851 children aged five to nine years, noting that a significant proportion of the disease can be prevented through safe drinking water and adequate sanitation and hygiene.

Globally, it noted that there are nearly 1.7 billion cases of childhood diarrhoeal disease every year and that diarrhoea is also a leading cause of malnutrition in children under five years old.

The WHO stated, “Diarrhoea can last several days and can leave the body without the water and salts that are necessary for survival. In the past, for most people, severe dehydration and fluid loss were the main causes of diarrhoea-associated deaths.

“Other causes such as septic bacterial infections are likely to account for an increasing proportion of all diarrhoea-associated deaths.

“Children who are malnourished or have impaired immunity, as well as people living with Human Immunodeficiency Virus, are most at risk of life-threatening diarrhoea.

“Diarrhoea is usually a symptom of an infection in the intestinal tract, which can be caused by a variety of bacterial, viral, and parasitic organisms. Infection is spread through contaminated food or drinking water, or from person to person as a result of poor hygiene.”

The United Nations agency stated that interventions to prevent diarrhoea, including safe drinking water, use of improved sanitation, and hand washing with soap, can reduce disease risk.

It further advised that diarrhoea be treated with oral rehydration therapy, a solution of clean water, sugar and salt.

The WHO stated that a 10 to 14-day supplemental treatment course of dispersible zinc tablets shortens diarrhoea duration and improves outcomes, insisting that 780 million individuals lack access to improved drinking water, while 2.5 billion, lack improved sanitation worldwide.

The global health body added that diarrhoea, due to infection, is widespread throughout developing countries and that in low-income countries, children under three years old experience on average three episodes of diarrhoea every year, with each episode depriving a child of the nutrition necessary for growth.

“As a result, diarrhoea is a major cause of malnutrition, and malnourished children are more likely to fall ill from diarrhoea,” the WHO added.

According to a Consultant Paediatrician at the Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Dr Adefunke Babatunde, the causative agents range from bacteria and viruses to parasites, infiltrating communities with ease, particularly in regions grappling with poverty, inadequate healthcare infrastructure, and limited access to clean water and sanitation facilities.

Babatunde said simple but effective measures such as handwashing with soap, safe food handling and preparation, and proper sanitation play a pivotal role in preventing the spread of diarrhoea pathogens.

She said, “Achieving widespread adherence to these practices remains a formidable challenge, especially in resource-constrained settings where access to basic amenities and education on hygiene practices is limited.

“Central to the fight against diarrhoea-related child mortality is the imperative to promote hygiene education and behaviour change at both individual and community levels.

“Empowering caregivers with knowledge about the importance of hand hygiene, safe water, and sanitation practices equips them with the tools to protect their children from diarrhoeal diseases.

“Moreover, fostering a culture of hygiene within communities fosters collective responsibility and resilience against the threat of diarrhoea outbreaks. The role of innovative interventions and technologies in bolstering hygiene practices and curbing diarrhoeal diseases can’t be overlooked.

“From water purification systems and improved sanitation facilities to behaviour-change communication strategies leveraging digital platforms, there exists a wealth of tools and approaches to enhance hygiene standards and mitigate the risk of diarrhoea transmission.”

She, however, said the successful implementation of such interventions hinges upon sustained investment, multisectoral collaboration, and community engagement.

A Consultant Gynaecologist and Obstetrician at the Epe General Hospital, Epe, Lagos State, Cynthia Okafor, said beyond the realm of individual behaviour change, addressing the structural determinants of poor hygiene and diarrhoeal diseases demands a multifaceted approach.

While urging parents to seek immediate medical attention when diarrhoea is suspected, she said strengthening the healthcare system, enhancing access to essential services, and investing in sanitation infrastructure are indispensable components of a comprehensive strategy to reduce diarrhoea morbidity and mortality among children.

She advocated for policies that prioritise water, sanitation, and hygiene initiatives, maintaining that allocating resources towards their implementation is essential for catalysing progress towards the Sustainable Development Goals target of ending preventable child deaths.

Okafor said in the quest to combat diarrhoea-related child mortality, it is imperative to prioritise equity and inclusivity.

She added, “Vulnerable populations, including those living in remote areas, informal settlements, and conflict zones, are disproportionately burdened by diarrhoeal diseases due to systemic inequalities and barriers to accessing essential services.

“Consequently, efforts to promote good hygiene must be guided by principles of equity, ensuring that marginalised communities have equitable access to clean water, sanitation facilities, and hygiene education.

“By redoubling our efforts to promote good hygiene practices, expand access to clean water and sanitation, and address the root causes of poor health outcomes, we can forge a path towards a future where no child succumbs to the preventable tragedy of diarrhoeal diseases.”

SOURCE: HealthWise