Diarrhea: Epidemiology, Prevention & Control

 Describe diarrheal disease
 Classify diarrheal disease
 Describe the epidemiology of diarrheal diseases
 Explain the clinical features, assessment and
diagnostic criteria of diarrheal diseases
 Discuss measure of control and prevention of
diarrheal diseases

1. Diarrheal Diseases and its Prevention
Dr Athar Khan
Professor, Department of Community Medicine
Liaquat College of Medicine & Dentistry
Karachi, Pakistan

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FINAL EXM
THEORY LM/RSP/CVS/GITL
UNOBSERVED OSPE LM/RSP/CVS/GITL
OBSERVED OSPE LM/RSP/CVS/GITL

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FINAL EXAM -JSMU
FM 10 Weeks
BLOOD 6 Weeks
LOCOMOTOR
RSP
CVS
GITL
4 Weeks
5 Weeks
4 Weeks
6 Weeks

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GIT & Hepatobiliary -2
Lecture % TutorialPractical
CM 15 20 ---- ----
FM 13 18 05 ----
Pathology
(GP)
38
51
01 05
Pharmacology 08 11 05 02
TOTAL 74 11 07

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LEARNING OBJECTIVES
Describediarrhealdisease
Classifydiarrhealdisease
Describetheepidemiologyofdiarrhealdiseases
Explaintheclinicalfeatures,assessmentand
diagnosticcriteriaofdiarrhealdiseases
Discussmeasureofcontrolandpreventionof
diarrhealdiseases

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MATCHING QUESTION
1.Water based
diseases
2.Water related
diseases
3.Waterborndiseases
4.Water washed
diseases
Infectionsspreadthrough
contaminated drinking
water
Diseasesduetothelack
ofpropersanitationand
hygiene
Infectionstransmitted
throughan aquatic
invertebrateorganism
Diseasestransmittedby
insectsthatdependon
waterfortheir
propagation
3,4,1,2

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MATCHING QUESTION
1.Water based
diseases
2.Water related
diseases
3.Waterbornediseases
4.Water washed
diseases
3,4,1,2,4

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DIARRHEA
Accordingto(WHO)“Diarrhea”ischaracterized
by:
1.3looseorliquidstoolsperday
2.2looseorliquidstoolsperday
3.3ormorelooseorliquidstoolsperday
4.2ormorelooseorliquidstoolsperday

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Themostimportanttreatmentincaseof
diarrheais:
1.Antibiotics
2.Fluidreplacement
3.Rest
4.Useboiledwaterfordrinking
Themostimportanttreatmentincaseof
diarrheais:

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MATCHING QUESTION
3. Acute Watery
Diarrhoea
1. Acute Bloody
Diarrhoea
2. Persistent
Diarrhoea
Lasts several hours
or days (2 weeks)
Dysentery
Lasts 14 days or longer
3, 1, 2, 2, 4
2 –4 weeks
> 4 weeks
4. Chronic Diarrhea

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MATCHING QUESTION
3. Acute Watery
Diarrhoea
1. Acute Bloody
Diarrhea (Dysentery)
2. Persistent
Diarrhoea
Rota Virus
Amebiasis
E. Coli
3,1,3,3,1
Cholera
Shigellosis
4. Chronic Diarrhea

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Epidemiology of Diarrheal Diseases
Secondleadingcauseofdeath
inchildrenunderfiveyears
Leadingcauseofmalnutritionin
childrenunderfiveyears
Themostseverethreatposedby
diarrhea
Epidemicsofdiarrheaiscaused
by
1.Dehydration
2.Vibriocholerae
3.Diarrhea
4.Shigella
dysenteriaetype1
5.Diarrhealdisease
5,3,1,2,5

14. •Reservoirofinfection
•Hostfactors(most
common)
•Environmentalfactors
•Bacterialdiarrhea
•Viraldiarrhea
•Modeoftransmission
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MATCHING QUESTION
1.Winter
2.Viraldiarrhea
3.Bacterialdiarrhea
4.Faecal-oralroute
5.6monthsand2
yearschildren
6.Man
7.Warmseason
6,5,1 & 7, 7,1,4

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Causes of Diarrheal Diseases
PoorPersonalHygiene
Infections( Rotavirus,
Escherichia coli)
Malnutrition
Contaminated Water
UnhygienicFood
UnsafeDomesticWaterStorage
FoodFromPollutedWater

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Clinical Features of Diarrheal Diseases

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Assessment & Diagnostic Criteria of Diarrheal
Diseases
Briefhistoryandexaminingthechild.
Detectdehydration
Diagnosedysentery
Diagnosepersistentdiarrhoea
Evaluatefeedingpractices
Determinethechild'snutritionalstatus
Diagnoseanyconcurrentillness;and
Determinethechild'simmunizationhistory,.

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PHYSICAL EXAMINATION

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General Danger Signs
Intra-Venous Liquid & Use Catheters

21. >2 seconds
< 2 seconds
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1.NoDiarrhea
2.SomeDehydration
3.SevereDehydration
4.NoDehydration
3,2,4

22. >2 seconds
< 2 seconds
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1.NoDiarrhea
2.SomeDehydration
3.SevereDehydration
4.NoDehydration
3,2,4

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1.NoDiarrhea
2.SomeDehydration
3.SevereDehydration
4.NoDehydration
3,2
>2 seconds
< 2 seconds

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1.PlanA
2.PlanB
3.PlanC
4. Refer urgently to
hospital
Up to 2 years 50 to 100 ml after each loose stool
2 years or more 100 to 200 ml after each loose stool
3,4, 2,1,1

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ORS in ml: 20044779914
ORS(ml) = Weight(kg) ×75

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HOME MADE ORS

27. HOME MADE ORS
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1level teaspoonholds 4g of sugar
One level teaspoon contains 7 grams of salt

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29. Vaccination should not be initiated for infants aged > 12 weeks.
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PREVENTION OF DIARRHOEAL DISEASES
Safedrinking-water
Improvedsanitation
Handwashing
Exclusivebreastfeedingforthefirstsixmonthsoflife
Goodpersonalandfoodhygiene
Healtheducation
Goodpersonalandfoodhygiene
Rotavirusvaccination

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34. Dr Athar Khan
Professor, Department of Community Medicine
Director, Department of Medical Education
Director, Research Cell
MBBS,MPH, DPH, MCPS(CM), MCPS(HCSM), MBA, DCPS-
HPE, PGD-Statistics, CCRP
[email protected]
[phone] (WhatsApp Only)
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