‘How to reduce diarrhoea-related deaths by 88%’

• PATHS2 takes zinc, ORS supplement campaign to community pharmacists

SOME innovations are so simple; you have to wonder why no one has come up with them before. One of such is zinc supplement and low osmolality Oral Rehydration Salts (ORS) therapy in the management of acute diarrhoea illnesses among children.

 Every single day, Nigeria loses about 2,300 children under-five years of age, according to United Nations Children’s Fund (UNICEF) report. These children are often vulnerable to life-threatening infections. Diarrhoea is one of these and it is the third largest single cause of child mortality (after malaria and pneumonia) in Nigeria.

  A child that passes three or more loose or watery stools over a period of 24 hours could be said to have diarrhoea. Both the consistency and frequency of the stools are important factors in diagnosing diarrhoea, often caused by rotavirus.

  According to experts, children may be prone to diarrhoea due to lack of safe and clean drinking water and exposure to poor sanitary and domestic hygiene. In addition, this can occur when children are not fully immunised, lack the proper diet according to their age’s dietary requirements or are immunocompromised.

  No fewer than 11 per cent of all child deaths in Nigeria is due to diarrhoea. That is, 90,970 under-five deaths annually, a United Nations Children’s Fund (UNICEF) 2010 estimate show.

  Six years before this dismal statistic, the World Health Organisation (WHO) and UNICEF endorsed low-osmolality ORS as the gold standard in managing diarrhoea globally, however it is still unpopular in Nigeria.

  At the recent Continuing Education Conference, by the Lagos branch of the Association of Community pharmacists of Nigeria (ACPN), in collaboration with Partnership for Transforming Health Systems Phase II (PATHS2) and Clinton Health Access Initiative (CHAI), experts raised awareness on prevalence of diarrhoea and called for paradigm shift in its management especially in the communities.

  Major complications of diarrhoea, as observed at the conference, are dehydration and malnutrition. In diarrhoea, the digestive system is less able to absorb fluids and nutrients. Also, there is an increase in the amount of fluids and minerals that the body secretes. These changes cause the body to lose fluids and minerals, like zinc, sodium and potassium. When these fluids and minerals aren’t replaced, this can lead quickly to dehydration and malnutrition. And zinc loss weakens the immune system, leaving a child less able to fight disease.

  Dr. Olasumbo Makinde of PATHS2 Lagos observed that the three essential elements in the management of all children with diarrhoea are: Rehydration therapy; zinc supplementation and counseling for continued feeding and prevention.

  The combination of zinc supplementation and low osmolality (concentration of a substance in a liquid) ORS is a recent development in the treatment of diarrhoeal episodes in children. From research, it has the potential to decrease diarrhoea-related deaths by up to 88 percent, with feeding and extra fluids.

 State Team Leader of PATHS2 in Lagos, Ibironke Dada, noted that by averting deaths from diarrhoea, by over 80 per cent, Nigeria’s progress towards the Millennium Development Goal (MDG)-four would accelerate as the MDG deadline draws near.

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