Global Epidemiology and Management of Acute Diarrhea in Children from Developing Countries - Abstract
Diarrheal disease remains one of the leading causes of death in children under the age of five years in developing countries. Extensive measures have been in effect in low-and middle-income countries (LMICs), worldwide, to provide clean water, good hygiene, and sanitary living conditions. However, many survivors continue to deal with persistent diarrhea and nutrient deficiencies, affecting their growth due to their low socioeconomic status. There are over 2.5 billion diarrheal illnesses cases annually, which account for an estimated 1,400 deaths daily, according to the World Health Organization (WHO). The lack of maternal education, insufficiency or early cessation of breastfeeding, poor handwashing technique, improper storage of food and water, and limited access to proper health facilities in developing countries has resulted in children facing severe dehydration and prolonged mucosal injury that ultimately results in their death. For the patients that can access healthcare, diagnosis is achieved by stool microscopy and culture. Furthermore, polymerase
chain reaction (PCR), has been used to test for Escherichia coli and norovirus to detect toxin-encoding genes, while enzyme immunoassay is used to detect other pathogens, such as Campylobacter, rotavirus, adenovirus, astrovirus, Entamoeba histolytica, Shigella, Giardia, and Cryptosporidium. Additionally, subsequent septic bacterial infections that result from inadequate care and poor management of diarrheal illness have resulted in the use of oral rehydration and antibiotics with a minimal resolution of persistent diarrhea in some patients. Several interventions that are being implemented in LMICs to combat diarrhea-related mortality, include providing educational resources to caregivers and healthcare providers, training caregivers to be able to detect early signs of deterioration in children, as well as purifying water and sanitation. Additionally, the importance of highly nutritious
foods and proper breastfeeding techniques for the first six months of life have been shown to provide children with stronger immune systems to enable them to combat infections.