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close this bookFact sheet No 178: Reducing Mortality from Major Killers of Children - Revised September 1998 (WHO, 1998, 7 p.)
View the document(introduction...)
View the documentIntegrated Management of Childhood Illness (IMCI)
View the documentPneumonia: correct management could save over 1 million lives per year
View the documentDiarrhoea: correct management could save nearly 1.8 million lives per year
View the documentMeasles: effective prevention and treatment could save 700 000 lives per year
View the documentMalaria: correct management could save 500 000 lives per year
View the documentMalnutrition: improved feeding practices could save 800 000 lives per year
View the documentOther prevention activities
View the documentResearch and development
View the documentImproving health systems
View the documentImproving health worker skills
View the documentImproving family practices

Diarrhoea: correct management could save nearly 1.8 million lives per year

Another two million children die each year in developing countries from diarrhoeal diseases, making it the second most serious killer of children under five worldwide. But diarrhoea can in most cases be prevented or treated. Correct management of diarrhoea could save the lives of up to 90% of children who currently die from the effects of the disease.

MCI reduces the death toll from diarrhoea by promoting:

· Rapid and effective treatment through standard case management;
· Prompt recognition and treatment of conditions that occur in association with diarrhoea;
· Improved home management;
· Improved nutrition;
· Prevention through increased breastfeeding and measles vaccination.

Diarrhoea may be caused by a wide variety of infections but health workers following the IMCI approach learn to make rapid treatment decisions by determining the duration of the diarrhoea, assessing the severity of dehydration and the presence of blood in stools. This leads them to selecting treatment protocols for either: persistent diarrhoea (more than 14 days), acute watery diarrhoea, or dysentery. This approach is both life-saving and cost-effective.

While urgent diagnosis and treatment of diarrhoea may be a priority for saving a child's life, IMCI-trained health workers also consider the child's overall health status. For example, by treating the malnutrition that often accompanies diarrhoea, further risk to the child's health can be reduced. Increasing vigilance to detect other diseases that can occur concurrently with diarrhoea, such as measles or malaria, is also emphasized.