Acute Diarrhoeal Diseases Assignment

1. Define diarrhea and describe the types of diarrhea

Ans: Diarrhoea is defined as the passage of loose, liquid or watery stools. It mainly depends
upon consistency and characters of stool than number of stools.

CLINICAL TYPES OF DIARRHOEAL DISEASE

Four clinical types of diarrhoea can be recognized, each reflecting the basic underlying
pathology and altered physiology:
(1) Acute watery diarrhoea - which lasts several hours to days.
Dehydration and weight loss are the major complications here or concerns. The pathogens
that usually cause acute diarrhoea include V.cholerae or E. coli bacteria, as well as rotavirus.
(2) Acute bloody diarrhoea - which is also called dysentery – it damage the intestinal
mucosa. Sepsis and malnutrition are the main concerns. Other complications including
dehydration. It is marked by visible blood in the stools. Shigella, a bacteria that is also a most
common cause of severe cases.
(3) Persistent diarrhoea - which lasts 14 days or longer. Malnutrition and serious non-
intestinal infection, dehydration are the major complications. Persons with other illness such
as AIDS, are more likely to develop persistent diarrhoea.
(4) Diarrhoea with severe ma/nutrition (marasmus and Kwashiorkor) - The main dangers
are severe systemic infection, dehydration, heart failure, and vitamin and mineral deficiency.

2. Write the composition of ORS

Ans In acute diarrhoea it is important to maintain water and electrolyte balance with proper
fluid replacement (rehydration). Oral rehydration seems to be the simplest safest and least
expensive method of choice for acute diarrhoea. WHO-ORS contains
1. Sodium chloride = 2.5 gms
2. Potassium chloride= 1.5 gms
3. Sodium citrate= 2.9gms
4. Glucose = 13.5 gms
Total weight of 20.5 gms
It has to be dissolved in 1 ltr of water. This provides
1. Sodium = 75mM
2. Potassium= 20mM
3. Chloride = 65Mm
4. Citrate = 10mM
5. Glucose= 75Mm
The total osmolarity is 245mOsm/L

3. Rotavirus vaccine
 Ans Two live, oral, attenuated rotavirus vaccines were licensed in 2006. The monovalent
human rotavirus vaccine and the pentavalent bovine-human, reassortant vaccine.
The monovalent vaccine is administered orally in a 2-dose schedule to infants of 2 and 4
months of age. The first dose is administered at the age of 6 weeks and should be given no
later than at the age of 12 weeks. The interval between the 2 doses should be at least 4 weeks.
The 2-dose schedule should be completed by age 16 weeks, and no later than by 24 weeks of
age.
For Pentavalent vaccine, the schedule is 3 oral doses at ages 2, 4 and 6 months. The first dose
should be administered between ages 6-12 weeks and subsequent doses at intervals of 4-10
weeks. Vaccination should not be initiated for infants aged > 12 weeks. All 3 doses should be
administered before the age of 32 weeks.
4. Describe the preventive strategies in control of diarrhoeal diseases
Ans
(i) SANITATION: Measures to reduce transmission emphasize the traditional improved
water supply, improved excreta disposal and improved domestic and food hygiene.
Without an adequate supply of clean water close to their homes, it is extremely difficult to
promote personal and domestic hygiene. Simple hygienic measures like hand washing with
soap before preparing food, before eating, before feeding a child, after defecation, etc should
be promoted. All families should have a clean and functioning latrine. The latrine should be
kept dean by regular washing of dirty surface. Because diarrhoea attack rates are higher
among children, it is the defecation in this age group that deserves the most attention.

(ii) HEALTH EDUCATION: Environmental sanitation measures require educational

support, to ensure their proper use and maintenance of such facilities. An important part of
health worker's job is to help prevent diarrhoea by convincing and helping community
members to adopt and maintain certain preventive practices such as breast-feeding, improved
weaning, clean drinking water, use of plenty of water for hygiene, use of latrine, proper
disposal of stools of young children etc.

(iii) IMMUNIZATION: Immunization against measles is a potential intervention for

diarrhoea control.

Rotavirus vaccine
The monovalent vaccine is administered orally in a 2-dose schedule to infants of 2 and 4
months of age. The first dose is administered at the age of 6 weeks and should be given no
later than at the age of 12 weeks. The interval between the 2 doses should be at least 4 weeks.
The 2-dose schedule should be completed by age 16 weeks, and no later than by 24 weeks of
age.
For Pentavalent vaccine, the schedule is 3 oral doses at ages 2, 4 and 6 months. The first dose
should be administered between ages 6-12 weeks and subsequent doses at intervals of 4-10
weeks. Vaccination should not be initiated for infants aged > 12 weeks. All 3 doses should be
administered before the age of 32 weeks.

(iv) FLY CONTROL: Flies breeding in association with human or animal faeces should be
controlled.

Multiple choice questions

1. Rationale behind zinc supplementation in Acute diarrhoeal disease management

 A. Reduce the severity and duration
B. Rehydration therapy
C. Correction of acidosis
D. None of the above
Ans A

2) What is the true statement for reducing the osmolarity of ORS

A. Avoid possible adverse effects of hyper tonicity on net fluid absorption
B. To make product affordable
C. Reducing osmolarity decreased the stool output and vomiting
D. Both A and C
Ans A