Up until this point, most of my coursework has focused on major global health issues like HIV/AIDS, maternal and child health, malaria, and collaboration strategies (to name a few). Of course, there are innumerable other global issues that need to be addressed, and I want to have some background knowledge of issues that I have not yet encountered. One that I think is universally significant and that I have heard about, but do not actually know much about, is diarrhea.
Diarrhea is not often heard about despite the fact that it is the second leading cause of death among children under the age of five. Besides that, diarrhea is a leading cause of childhood malnutrition and dehydration. All of these are unfortunate consequences given that diarrhea is both preventable and treatable.
Diarrhea is the frequent passing of loose or liquid stools, usually due to an infection in the intestinal tract. This infection is typically contracted from contaminated water or food sources or poor hygiene, and is aggravated by previous infections, malnutrition, continued poor sanitation, and lack of safe drinking water. The condition is treated by ingesting clean water and electrolytes to replace those expelled by the body, balanced nutrition, zinc supplements, and in some cases can be treated with over-the-counter medicines. Prevention is ideal to avoid diarrheal infections completely, measures which include clean or treated drinking water, personal hygiene, breastfeeding infants, and vaccinations.
Unfortunately, the people diarrhea affects the most tend to not have access to safe drinking water, electrolytes, or medicine–often children living in extremely impoverished circumstances. Children living in such conditions face higher risk of ingesting contaminated water or food in tandem with poorer sanitation and thus experience increased rates of diarrheal disease. Once contracted, diarrhea can exacerbate already existing malnutrition, cause malnutrition, or cause moderate to severe dehydration; all of which can, without proper treatment, result in death.
Diarrheal infections are more prominent in some regions than in others: for instance, one quarter of deaths related to diarrhea occur in India. Hundreds of thousands of impoverished individuals face a lack of access to safe water, food, and medical care, leaving them without prevention or treatment to prevent diarrheal infections. Though there is currently a surge in vaccination interventions, there are still high incidence rates of diarrhea in India because widespread environmental sanitation has proved challenging to achieve.
Another country exhibiting extremely high rates of diarrhea is Nigeria, which, like India, has unsanitary food and water sources and already high rates of malnutrition, all of which compound the contraction of diarrheal infections. However, Nigeria has taken a different approach to combatting high diarrheal rates, choosing to focus on hand-washing campaigns to encourage personal hygiene as a prevention strategy. UNICEF’s study of these hand-washing interventions have found that hand-washing can reduce diarrhea prevalence by about 30%.
Dr. Evan J Anderson of Northwestern University’s Feinberg School of Medicine has done extensive research on the prevention and treatment of viral diarrhea. His research investigates the viruses that cause diarrhea, identifying rotavirus and norovirus as the two leading viral causes. Dr. Anderson lists the prevention strategies outlined above, paying particular attention to vaccination. There are two new vaccines–Rotarix and RotaTeq–that have greatly reduced morbidity in the countries that use them. There are also efforts being made to develop another vaccine that combats norovirus.
Besides these prevention and treatment strategies, what can be done to help decrease diarrheal infections? First and foremost, investment in safe drinking water and sanitation must be a priority for growing infrastructures in developing nations. Present and future health interventions in regions with high prevalence of diarrhea-related issues can focus on sanitation, constructing safe wells, introducing iodine water treatments, and educating people. Furthermore, health workers can be trained to identify, treat, and prevent diarrhea and related conditions. Regardless, it is important to recognize the global severity of diarrhea–gaining a basic understanding of the issue can at least provide a foundation for more in depth action.