By Dr Joel Akande
Diarrhoea is a common disorder in our environment. While not exclusive to filthy environment, diarrhoea is a commonly occurring illness in poor personal and environmental hygiene.
What is diarrhoea?
World Health Organisation (WHO) defines diarrhoea as “the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the individual). Frequent passing of formed stools is not diarrhoea, nor is the passing of loose, “pasty” stools by breastfed babies.”
The disease of diarrhoea is a killer disease, especially in children whereby it kills over 525, 000 children globally every year. In Nigeria, the disease is a major cause of death in children and adults. Like all symptoms, diarrhoea is an indicator of an underlying infection in the food tract (intestinal) or an ongoing disease entity.
How is diarrhoea contracted? Diarrhoea being due to infection may be caused by viruses, bacteria or parasites. As I have mentioned above, disease of diarrhoea is a disease of poor hygiene. The disease is spread through infections bacteria (typhoid, E. coli, cholera and so forth), viruses and parasites that contaminates our food and water or spread from one person to the other as a result of poor hygiene.
Types of diarrhoea:
Acute watery diarrhoea
This type lasts several hours or days, and includes cholera.
Acute Bloody Diarrhoea
This type is also called dysentery
This lasts 14 days or longer.
Consequences of diarrhoea as a disease state.
The most serious results of suffering from diarrohea is the loss of water and nutrients such as salts (sodium, potassium and bicarbonate) through stooling, vomiting, sweating and low intake of the same leading to dehydration, weakness, confusion and collapse.
Other results of diarrhoea are sunken eyes, loss of weight, poor appetite for food and water. The person may also become restless, irritable or drinks eagerly.
Causes of diarrhoea
Infection: As I had earlier mentioned, diarrhoea is a symptom of infections caused by a lot of germs, most of which are spread by faeces and water that are contaminated. Infection is even more likely in places where there is inadequate sanitation and hygiene. In places suffering with poor safe water for drinking, cooking and cleaning, diarrhoea is not far away. Examples of agents or organisms that causes the illness are Rotavirus and Escherichia coli, which are the two most common agents causing moderate-to-severe diarrhoea in low-income countries such as Nigeria. Other germs such as cryptosporidium and shigella species may also play some important roles.
Malnutrition: On the average, majority of Nigerians earn poorly. This is also reflected on their children who may also suffer from poor nutrition. Children who die from diarrhoea often suffer from underlying malnutrition, which makes them more vulnerable to diarrhoea. Ironically, each diarrhoeal episode, makes malnutrition even worse. On the whole, diarrhoea is a leading cause of malnutrition in children under five years old, the world over, including Nigeria.
What are the source of contamination?
Water contaminated with human faeces/stools, for example, from sewage, septic tanks and latrines, is of particular concern. Faeces near food, faeces on the roads, are potential sources of contamination of foods and water. Animal faeces from say from cows, dogs, goats and so forth also contain microorganisms/germs that can cause diarrhoea.
Diarrhoeal disease can also spread from one person to the other, made worse by poor personal hygiene. Food is another major cause of diarrhoea when it is prepared or stored in unhygienic conditions. All foods should be stored securely in say in refrigerator if appropriate. Re-heat stored food thoroughly so that the germs and toxins may be inactivated. Poorly kept home water storage and handling is also an important risk factor for diarrhoea. Seafood such as crabs and fish from polluted water may also contribute to the illness.
Drink only clean, well- treated and well sourced water. Dispose your feaces thoroughly. If possible, eat only from home or in food vendors with proven hygienic environment and food handling. The fact that a food vendor is popular or well branded is not a license of good food handling. Wash hands with soap after visiting toilet.
Hand washing prevents infection generally. There is no substitute for good personal hygiene and clean environment. For children, vaccination against rotavirus is available. For newborn, exclusive breastfeeding for the first six months of life helps prevent diarrheoa disease.
Immediate commencement of rehydration is crucial. Oral rehydration therapy with salt, water and sugar solution should be commenced soonest in both adult and more importantly in children. Zinc tablet taken as appropriate may stem the tide of the disease of diarrhoea. When these domestic measures cannot stop the disease, immediate visit or call to health professional is needed. Treatment may include investigation of the cause and administration of antibiotics and intravenous fluids as the case may be.
Do not delay. Diarrhoea is lethal and it kills.