Running head: GROUP 4 MINI RESEARCH PAPER ONE 1

Group 4 mini research paper: Diarrheal disease in chad

Augustus Zuo

HLSC460 - UMKC

02/24/2015

GROUP 4 MINI RESEARCH PAPER ONE 2

The global health issue that group four is analyzing this semester is diarrheal disease, and

more specifically how it effects children in the African country of Chad. Diarrheal is defined as

the passage of three or more loose liquid stools per day (World Health Organization [WHO],

2013). It is usually caused by an infection in the intestinal tract and can be spread through

contaminated food, drinking water, and poor hygiene (WHO, 2013). Annually, 527 thousand

children under the age of five die from complications of diarrheal disease (Waggie, Hawkridge,

Hussey, 2010). Diarrheal disease is currently a large problem in poor countries such as Chad,

however with the right tools it is both treatable and preventable.

There are three clinical types of diarrhea. The Acute diarrhea lasts about less than two to

three weeks. The acute diarrhea can be caused by infection such as bacterial, parasitic or viral

invasion, or by a non-infectious agent such as dietary indiscretion or a new medication (WHO,

2015). There are other organisms that can also cause acute diarrhea. They include Norwalk

virus, Rotavirus, Staphylococcus aureus, Clostridium perfringens, and Vibrio cholera and enter

toxigenic Escherichia coli. Chronic diarrhea can last for more than two weeks (WHO, 2015). It

is can also be called persistent diarrhea. Chronic diarrhea can be cause by disease processes,

medication, genetic abnormalities, or a variety of other causes (WHO, 2015). Secretory Diarrhea

happens when there is an increase in fluids and a decrease in absorption (WHO, 2015).

According to the World Health Organization, it is the second leading cause of death in

children under five years old (WHO, 2013). Sub-Saharan Africa and Southeast Asia accounts

for 90 percent of the deaths in children under five, caused by diarrheal disease (Waggie et al.,

2010). The country of Chad is among the top 15 countries with the greatest number of child

deaths due to diarrhea (International Vaccine Access Center [IVAC], 2014). Nearly 29 percent

of deaths occurring in children under five is attributed to diarrheal disease (Waggie et al., 2010).

GROUP 4 MINI RESEARCH PAPER ONE 3

The most common cause of diarrheal disease is Rotavirus, a vaccine preventable disease

(Waggie et al., 2010). Clearly, this is an important issue, affecting poor countries more than

wealthy countries due to inequities in health care and resources.

There are several economic, social and cultural factors negatively affecting the issue of

diarrheal disease in children. Chad recently deployed troops to Cameroon to help defend them

from Boko Haram; this conflict causes instability and threatens security in the region (allAfrica,

2013). Global warming is another economic factor negatively affecting Chad because it is

making agriculture more difficult, which is the majority of the populations’ main source of

income (Our Africa, 2015). Only 75 percent of children in Chad are enrolled in school, and most

schools have a shortage of materials, and lack running water and electricity (Our Africa, 2015).

The majority of the children who do attend school are boys because the Chadian’s believe that a

girls education is less important than a boys, the girls typically stay home (Our Africa, 2015).

Due to a lack of education for women in Chad, only 40% of women between the ages of 15 to 24

are literate (Our Africa, 2015). Conflict in the region, a shortage of available jobs, and minimal

to no education are all contributors to poor health outcomes in Chad, including diarrheal disease

in children under five.

The Bill and Melinda gates foundation is working towards reducing the burden of

diarrheal disease in children under five in low income countries like Chad (Bill and Melinda

Gates Foundation [BMGF], 2015). The primary goal of the foundation is to supply an adequate

amount of vaccines, primarily the Rotovirus vaccine, to low income countries in an effort to

prevent children from acquiring the diarrheal disease (BMGF, 2015). Another goal in progress is

to supply Oral Rehydration Solution (ORS) to regions with a high number of children suffering

from diarrheal disease (BMGF, 2015). “ORS is a special combination of dry salts that is mixed

GROUP 4 MINI RESEARCH PAPER ONE 4

with safe water” (WHO, 2103). “It can help replace the fluids lost due to diarrhoea” (WHO,

2013). Along with supplying ORS, it will be necessary to educate the parents about when to give

their children the solution (BMGF, 2015). For example, a guideline that is to be followed for a

parent to treat their child is to educate a parent that within a days’ time, if their child has 3 or

more mixed stools. Then that is when they would begin to treat with ORS (WHO, 2013). Also it

is important to teach people where ORS packets can be found. ORS packets can be found in

health centres, pharamacies and shops (WHO, 2013). ORT is another option for families and

may even be more realistic depending or severity and access to aid. ORT (Oral Rehydration

Therapy) can be made in the home (Greenough, n.d.). There are other organizations working on

creating a clean water supply, to aide in preventing the spread of disease (Our Africa, 2015). It

will take time, but there are positive factors contributing to the effort to improve the health of

children in Chad, and other African countries.

Along with a clean water source, people in Chad and other low income countries are in

need of places to go to the bathroom. People need toilets for basic human dignity, and to create a

more sanitary environment that will not pollute the water. Sulabh International Social Service

Organisation (Sulabh) is making an effort to provide inexpensive and sanitary toilets to properly

collect and dispose of human waste in low income countries (Sulabh, 2015). Two important

statements noted on Sulabh’s website are: “The US National Sanitation Foundation defines

sanitation thus: “It is the quality of living expressed in clean homes, clean farms, clean

neighbourhoods and clean community. Being a way of life, it must come from people, nourished

as it is by knowledge and it grows as obligation and ideal in human relations” (Sulabh,

2015).”The Second is, “Accordingly, environmental sanitation is viewed as “the control of all

those factors in man’s physical environment which exercise a deleterious effect on his physical

GROUP 4 MINI RESEARCH PAPER ONE 5

development, health and survival” (Sulabh, 2015). Access to proper waste disposal and

education regarding proper waste disposal is a good example of providing a population with

sustainability.

Nutrition is also very important in lowering the incidence of diarrheal disease.

“Nutritional support is just as important as resistance and increases the duration of diarrhea.

Nutritional support through breast feeding and improved weaning practices using high density,

easily digestible, local foods is especially important during and after episodes of diarrhea”

(Greenough, n.d.). Another aspect of decreasing diarrheal disease is promoting hand washing,

specifically with soap. “The immediate preventive impact can be achieved by promoting hand

washing with soap” (Greenough, n.d.). An important element as well is how well children’s’

stool is being discarded (Greenough, n.d.). This is important because this stems directly back to

a safe clean water source. “Diarrhoeal disease is a leading cause of mortality and morbidity in

the world, and mostly results from contaminated water food and water sources” (WHO, 2013).

Another way the burden of disease can be lifted from amongst the people are to for them to have

support from their local government. But it is unfortunate because all though it should be that

simple to receive support from local govenment, it is not. “A government without funds and

social programs has forced citizens to rely on their own resources, though some are occasionally

assisted by foreign (many French) nongovernmental organizations, such as Doctors without

Borders and various missionary organizations. Islamic and Christian as well as some ethnic

associations of self-help also exist” (Countries and their Cultures, n.d.). There are also not

enough health care workers to support the people that need health attention (Health, n.d.). As

discussed in class 02/17/2015 and 02/19/2015, the country will train their own health care

professionals or will pay to have them train elsewhere, but the aftermath is usually the same

GROUP 4 MINI RESEARCH PAPER ONE 6

outcome as if they did not invest in their the health care professionals at all; there are hardly any

health care workers (Health, n.d.). Many health care workers leave to places like the U.S for

example. Not all countries allow the entrance of health care professionals from other countries.

The UK for example have a code that does not actively recruit health care professionals from

Sub-Sahara Africa (Health, n.d.).

Overall, there are several contributing factors that cause diarrheal disease to be such a

prevalent problem in children under the age of five in developing countries. There are simple

changes that would help prevent diarrheal disease, and improve the health outcomes of children

who get diarrheal disease. Vaccinations, sanitation, proper waste disposal, education, and good

nutrition would help to combat diarrheal disease in developing countries. If developed nations

are willing to work together, it is possible to make these simple changes, and to save the lives of

millions of children.

GROUP 4 MINI RESEARCH PAPER ONE 7

References

Africa New gloal study inpoints main causes of childhood diarrheal disease. (2013, January 1).

Retrieved January 1, 2015, from http://allafrica.com/stories/201305141122.html

Chad. (2015, January 1). Retrieved January 1, 2015, from http://www.our-africa.org/chad

Countries and Their Cultures. (n.d.). Retrieved February 20, 2015, from http://www.everyculture.com/Bo-Co/Chad.html

Diarrhoeal disease. (2013, January 1). Retrieved January 1, 2015, from

http://www.who.int/mediacentre/factsheets/fs330/en/

Enteric and diarrheal diseases strategy overview. (2015, January 1). Retrieved January 1, 2015,

from http://www.gatesfoundation.org/What-We-Do/Global-Health/Enteric-and-

Diarrheal-Diseases

Greenough WB 3rd, T. (n.d.). Control Of Diarrheal Diseases. Retrieved February 20, 2015, from

http://www.ncbi.nlm.nih.gov/pubmed/2655632

Health. (n.d.). Retrieved February 20, 2015, from http://www.our-africa.org/health

Pneuonia and diarrhea progress report 2014. (2014, January 1). Retrieved January 1, 2015, from

http://www.jhsph.edu/research/centers-and-institutes/ivac/resources/IVAC-2014-

Pneumonia-Diarrhea-Progress-Report.pdf

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Sanitation. (2015, January 1). Retrieved January 1, 2015, from

http://www.sulabhinternational.org/content/sanitation

Waggie, Z., Hawkridge, A., & Hussey, G. (2010). Review of rotavirus studies in Africa: 1976-

2006. Journal Of Infectious Diseases, 202S23-33. doi:10.1086/653554