Friday, 30 December 2016

The Rising Incidence of Diarrhea in India

Diarrhea is the second leading cause of child mortality, worldwide. As estimated by Health Ministry, over 1.2 lakh children aged less than five years, succumb to diarrhea every year. The mortality rate is of 5 per 1000 live births in the country, as stated in an annual report released by International Vaccine Access Center.  

The primary factors which contribute to Diarrheal attacks among children are:
  •          contaminated water and food
  •          malnutrition
  •          inadequate sanitation and
  •          lack of immunization
The diarrheal disease further compromises the health of the child by hindering development, cognitive impairment and poor immune response.

According to a new research published in The Lancet, the number of cases of children dying from Diarrhea was twice as high as estimated previously. The attributable pathogens – Viruses, parasites, bacteria and other infections has been substantially underestimated. The research consisted of analysis of over 1000 samples from Bangladesh, India, Pakistan, the Gambia, Kenya, Mali and Mozambique. Its findings included that shigella and rotavirus were the most common infections among children below the age of 5. The other infections were followed by adenovirus, enterotoxin-producing E coli (ETEC), Cryptosporidium, and Campylobacter. The study concluded that while there is an oral vaccine that exists for rotavirus, a need was highlighted for shigella and ETEC vaccines which should to be prioritized. Diarrhea can also be managed through supportive care with rehydration and zinc supplementation. The use of antibiotics is not usually recommended unless there are signs of dysentery or if cholera is suspected.

Progress in immunization coverage is now being made in India with the introduction of rotavirus vaccine in Haryana, Andhra Pradesh, Himachal Pradesh and Odisha in 2016. There is a further expansion plan in March 2017 where the vaccine will be introduced in in the state of Rajasthan.17.25 lakh children will benefit from this introduction. Along with Rajasthan Tripura, Assam, Madhya Pradesh and Tamil Nadu in second phase. There are also simple proven interventions that can prevent death, including vaccines, antibiotics, exclusive breastfeeding, and access to treatment and care.

"It may not be possible to stop incidence of diarrhea by intervention but prevent deaths from it," says CK Mishra, additional secretary to the Health Ministry.

In India, only 54.4% children suffering from diarrhea receive ORS, whereas 30% of children are malnourished and are therefore, at an increased risk of getting the infection. We urgently need to find approaches to escalate the deployment of solutions to ensure that there is continued positive progress in reducing preventable child deaths.

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