Dehydration: Main cause of death in childhood diarrhoea

1,499,146 cases of diarrhoea were reported among children under five years in 2018. [iStockphoto]

Diarrhoea is among the common diseases resulting in the death of hundreds of thousands of newborns and infants in Kenya and globally.

In Kenya, in 2018, at least 1,499,146 cases of diarrhoea were reported among children under five years, where Nairobi accounted for 136,028 of the cases.

Dr Elizabeth Jowi, a paediatrician at Mama Lucy Hospital in Nairobi, defines diarrhoea as passing three or more loose bowel motions per day or having looser and more frequent bowel movements per day.

Diarrhoea, she says, may either be of acute onset (less than 14 days) or chronic (lasting more than 14 days).

The disease is mainly spread through fecal-oral route, from contamination of food and water sources by pathogens.

“Diarrhoea usually presents as an increase in the frequency of stool motions. It is important also to note the characteristics of the stool - how many episodes per day, the colour of the stool, any mucus present in the stool or any blood noted in the stool” explains Dr Jowi.

She adds “Diarrhoea may also be accompanied by other symptoms such as vomiting, nausea, abdominal pain, elevated temperature (fever), poor appetite, lethargy and dehydration”.

Diagnosis of diarrhoea, according to the paediatrician, is based on clinical presentation.

The specific cause of diarrhoea can be determined by doing stool tests (microscopy, culture and sensitivity for bacteria and parasites, or viral assays for viral causes).

Dr Jowi notes that, in children, diarrhoea is mainly caused by infectious agents such as rotavirus, bacteria like cholera, and parasites. 

Other causes of diarrhoea in children include overuse of antibiotics, side effects of drugs, food poisoning, food allergies or illnesses affecting the intestinal tract.

“Though all children, in general, are at risk of getting diarrhoea given their weakened immune system compared to adults, those with severe acute malnutrition, HIV infected children or those with limited access to clean water and sanitation services are at high risk of diarrhoea,” she says.

The doctor advises mothers to detect early signs of diarrhoea in babies.

“Mothers should take their children for diarrhoea checkup if they discover they present with dry lips, reduced production of tears, irritability, sunken eyes, reduced urine output, cold peripheries (hands and feet), rapid breathing and altered level of consciousness,” advises Dr Jowi. 

Most viral diarrhoeas, she says, are self-limiting (heals with time), but the danger with diarrhoea is dehydration, which causes death.  

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