Download - Acute Diarrhoeal Diseases
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by Deepanksha datta
Thendrals’06
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DIARRHOEA
DEFINITION
The passage of loose , liquid or watery stools
More than 3 times a day
ImportantThe recent change in the consistency and
the character of the stool
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TYPES Distinction between the ACUTE and
CHRONIC is ARBITRARY
CHRONIC – lasting for 3 weeks or more ACUTE ( WHO / UNICEF DEFINITION)
Attack of sudden onset , lasting for 3 to 7 days – may upto 10 -14 days
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Mainly due to infectionsGASTROENTRITIS – described as Diarrhoeal
Disease
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PROBLEM STATEMENTEquals RESPIRATORY INFECTIONS in
the morbidity worldwideWHO – Diarrhoeal Diseases Control
Programme 1980
ORS ADMINISTRATION
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COURTESY – WHO SITE
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RESULTS Mortality of the diarrhoeal diseases NO CHANGE IN THEOVERALL INCIDENCE
OF THE DISEASE
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INDIA Major health problem among children of age
under 5 years
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NATIONAL DIARRHOEAL DISEASE CONTROL PROGRAMME
EFFECTS OF THE DIARRHOEAL DISEASE
ECONOMIC BURDEN ON HEALTHSERVICES
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WHO 2005 SURVEY
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COMPARISON B/T COUNTRIES(WHO)
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EPIDEMIOLOGICAL DETERMINANTS
AGENT FACTORS
RESERVOIR OF INFECTION
HOST FACTORS
ENVIRONMENTAL FACTORS
MODE OF TRANSMISSION
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AGENT FACTORS
In the developing countries - INFECTIOUS in origin
VIRAL BACTERIAL
OTHERS
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VIRAL AGENTSRota virusAstro virusAdeno virusCalci virusCorona virusNorwalk virusEntero virus
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BACTERIAL AGENTSCampylobacter jejuniEscherichia coliShigellaSalmonellaVibrio choleraVibrio parahemolyticusBacillus cereus
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OTHER INFECTIOUS AGENTSEntameoba histolytica
Giardia intestinalis
Trichuriasis
Cryptosporidium
Intestinal worms
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ROTAVIRUS
Leading cause of SEVERE , DEHYDRATING DIARRHOEA IN CHILDREN < 5 YEARS .
First Episode Developing countries – ¾ children – before
12 months Developed countries – 2 – 5 years
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ROTAVIRUS (cont)ReinfectionPrimary infection – significantTemperate – WinterTropical – year roundHigh concentration shed in – stool and vomitTransmission – faeco- oral route person – person contaminated food
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BACTERIAL
ETEC (ENTEROTOXIGENIC E . COLI)Acute watery diarrhoea in adults & childrenMost common cause of the TRAVELLER’S
DIARRHOEA Heat labile and heat stable toxins – cholera
toxins
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BACTERIAL (CONT)C . Jejuni – no toxin
Salmonella – inflammation of the bladder
Shigella - high mortality %age – 69% among young children
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OTHERS INFECTIOUS AGENTSParasites – in the duodenum and the jejunumMost important CRYPTOSPORIDIUMImportant and the undiagnosed cause of
the death among the infantsImmunodeficient patientsDomestic animals
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PARENTRAL INFECTIONSNon digestive origin ENT INFECTIONS RESPIRATORY INFECTIONS URINARY TRACT INFECTIONS MALARIA MENINGITIS TEETHING
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MALNUTRITION
INBORN ERRORS OF METABOLISM - Health gap – developed countries- enzyme deficiency, severe infection
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who definition of aids for children
an episode of diarrhoea more than 30 days of duration
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RESERVOIRS OF INFECTION
MAN ANIMALETEC C. JEJUNISHIGELLA SALMONELLAE.COLI CHOLERAPARASITES
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HOST FACTORSDIARRHOEA- 6 MONTHS- 2 YEARSHighest incidence – 6 – 11 months REASONSDecreased maternal AbLack of the acquired immunityContaminated foodCrawling initiation
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Malnutrition – vicious circlePoverty PrematurityReduced gastric acidityImmunodeficiencyLack of personal & domestic hygiene
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ENVIRONMENTAL FACTORSDistinct seasonal variationsTEMPERATE REGIONS Bacterial – warm season Viral - winterTROPICAL REGIONS Bacterial – warmer , rainy Viral - dry , cold
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MODE OF TRANSMISSIONFaecal – oral route Water – borne Food – borne
OTHERS Direct – fomites , fingers, dirt – mainly for tye
children.
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BOOGIE FEVER
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REFRENCESWHO SITE WHO JOURNAL 2005 ISSUESPARK AND PARKGOOGLE.COMCARTOONSTOCK.COM
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