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Diarrhoea Outbreak Alert!!!

Publishing Date : 25 September, 2018

DR BOIMA
HEALTH ISSUES

Diarrhoea is the second leading cause of death in children below the age of 5 across the world as stated by World Health Organisation (WHO). Approximately Eight Hundred Thousand (800,000) children below the age of 5 succumb to this very preventable disease every year.


The public is thus notified that we are having such an outbreak in the country currently. Ministry of Health and Wellness has through its Minister, Dr Alfred Madigele released a press statement, confirming the 1 776 cases that have been reported nation-wide, saying that was the highest number recorded in the last five years for this time of the year. This figure may in fact be more as some cases may go unreported especially those that are handled in private facilities with no reporting tools or those in very remote areas where access to a health care facility is an issue.
 

The mortality rate is now standing at six, recorded at various health facilities around the country. Dr Madigele has continued to say it was not yet clear as to what may have caused the outbreak and that tests were being conducted to find the cause. Though many people have been suspecting Rotavirus, he said the Rota virus had not been ruled out nor had it been confirmed yet.


The public is cautioned to stick to best health practices such as handwashing immediately after using the toilet and before touching food and boiling drinking water. The most important thing is also for parents to know how to approach this kind of cases at home to prevent death. Parents should be able to recognize a sick child that needs medical attention and most importantly what to do and what not to do when they have children with diarrhoea at home.

Care at home

Children with mild diarrhoea can be looked after at home. High Fluid Intake - The main treatment is to keep the child drinking lots of fluids as young babies and children can become dehydrated very easily. This is needed to replace fluid lost due to the diarrhoea (and vomiting). It is important for the fluids to be taken even if the diarrhoea seems to get worse as some parents have a tendency of withholding fluids when they think they worsen the symptoms (having more diarrhoea). Older children should be given one cup (150-200ml) of fluid for every episode of diarrhoea or big vomit
Continue feeding - For breastfeeding or bottle-feeding babies, it need not be stopped
Isolation - The child needs to be kept away from other children as much as possible until the diarrhoea has stopped
Handwashing - Parents should realize that their children are infectious, so they need to wash their hands well with soap and warm water, particularly before feeding and after changing nappies

When to see a Doctor

According to the Royal Children’s Hospital (Melbourne) protocol, the following should prompt the parents to ditch the home-based care and take their children to the hospital;
If the child has signs and symptoms of dehydration (not passing urine/no wet diapers, is pale and has lost weight, sunken eyes, cold hands and feet, crying without tears, not playing or is hard to wake up)
If the child is not eating/drinking and still has diarrhoea (and vomiting)
If the child has a lot of diarrhoea (8-10 watery motions, or 2 or 3 large motions per day) or diarrhoea has taken more than a week
If the child is vomiting frequently and seems unable to keep any fluids down
If the child has bad stomach pains/cramps and is irritable
If there is blood in the diarrhoea
If the vomit is green in colour
If the child has fever
Babies under 6 months
OR if a parent is worried for any other reason
Treatment

Efficient treatment resides in prompt rehydration through the administration of oral rehydration salts (ORS) or intravenous fluids (drip), depending of the severity of cases.
Zinc sulphate tablet forms part of the treatment too, and it should be taken for at least 10 days, even if the child’s condition improves.

Prevention

Wash your hands with soap — after using toilets and latrines, before preparing food and before eating
Make sure the food is well done or well cooked
Store foods properly (in an air-tight closed container and refrigerated)
Always have fresh or freshly prepared foods (not stored for more than 2 days in the fridge)
Rotavirus vaccine is available in developing countries, either on national vaccination schedule or privately (as is the case in Botswana)
Children need to be up to date with all their immunizations
Good sterilization techniques of bottles (with Milton or by putting in boiling water for a while) for babies who are bottle-fed
Always sterilize the water before giving it to a baby

What not to do

Do not take the baby to a traditional doctor when symptoms get worse as the baby may be misdiagnosed and conventional treatment be delayed (e.g. sunken fontanel’s due to dehydration can often be diagnosed as ‘phogwana’ and mistreated
Do not give traditional medicines to reduce the diarrhoea or vomiting. They do not work and in most cases are very harmful
Do not give sports drinks, undiluted lemonade, cordials, or fruit juices to the child. They are not good in rehydrating the baby and are full of sugar and may only make the symptoms worse
Do not restrict food or fluids because of the ongoing diarrhoea or vomiting. Studies have shown that there is no role or need as far as gastroenteritis is concerned in doing this
Dr. Boima is the Managing Director of The Medics Centre, Palapye

themedicscentre@gmail.com

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