The phrase
"diarrhoeal disease" refers to an illness or infection that affects the digestive system, causing frequent and watery stools or diarrhea.
Full definition
And confirmed cases of
diarrhoeal disease in Baghdad are increasing, says Nada Doumani, spokeswoman for the International Committee of the Red Cross.
In all infants, the PAF
for diarrhoeal disease associated with formula compared with exclusive breast milk was 53 % when sterilising with chemicals / steam and 13 % when not sterilising with chemicals / steam.
Months since breast feeding cessation and duration of breast feeding were both significantly associated
with diarrhoeal disease, but much of these effects were due to the inclusion of the currently breast fed and never breast fed infants; neither was statistically significant when these infants were omitted.
Few studies have assessed whether the effect of breast feeding varies within a setting6 — 8 or examined the role of inadequate sterilisation.9 The present study aimed to measure the effect of breast feeding
on diarrhoeal disease in 1990s England, to determine whether this effect varied by social deprivation, and to assess whether inadequate sterilisation is a risk factor.
1.35 million people in developing countries, most of them children, die every year
from diarrhoeal diseases associated with lack of access to safe drinking water, inadequate sanitation, poor hygiene and overcrowding.
Bert Hirschhorn, an international editorial adviser since the start of the newsletter in 1980, looks at progress in the control of
diarrhoeal diseases over the last 12 years and outlines future challenges.
Household income has been shown to interact with child growth in Brazil.21 A US study of
diarrhoeal disease found no interaction between breast feeding and household income.8 Household income, like social class, may not be a good marker of transmission risk.
Formula milk was associated with nearly a fourfold increase in
diarrhoeal disease compared with exclusive breast milk in infants aged under and over 6 months (table 2).
In formula fed infants, there was significantly
more diarrhoeal disease in those not sterilising bottles / teats with steam or chemicals.
In order to assess whether the effect of breast feeding on
diarrhoeal disease persisted beyond the period of breast feeding, we examined the effect of past breast feeding in infants currently being formula fed.
Several risk factors for diarrhoea have been identified and have been the focus of specific interventions to
reduce diarrhoeal diseases.
The dangers of this must be emphasised because of the widespread use of feeding bottles in many developing countries
where diarrhoeal diseases are endemic.
Less publicly, the children of Baghdad are still dying of typhoid and
diarrhoeal diseases because the international trade embargo on Iraq has prevented water supplies from being fully restored after the Gulf War bombing four years ago.
Over the following month, thousands more perished — some from severe respiratory infections from the ash that remained in the atmosphere in the aftermath of the eruption, others from
violent diarrhoeal disease, the result of drinking water contaminated with acidic ash.
Cholera is an
acute diarrhoeal disease caused by ingesting food or water contaminated with the bacterium, Vibrio cholerae.
With health resources diverted to treating direct casualties of war, Popal fears the rise of
diarrhoeal diseases like cholera, typhoid and measles.
Yet already 1.1 billion people lack access to safe drinking water, 2.6 billion people lack adequate sanitation, and 1.8 million people die every year from
waterborne diarrhoeal diseases.
Our new findings confirm that breast feeding protects
against diarrhoeal disease in infants in England, but suggest that the degree of protection may vary across infants and wear off after cessation of breast feeding.
To investigate, scientists at the International Centre for
Diarrhoeal Disease Research in Dhaka, Bangladesh, and Massachusetts General Hospital in Boston examined 361 children and adults with cholera.
Results: After adjustment for confounders, breast feeding was associated with significantly
less diarrhoeal disease.
Co-authors of the publication include scientists from the International Centre
for Diarrhoeal Disease Research in Bangladesh, UC - Berkeley, the Johns Hopkins Bloomberg School of Public Health, UC - Davis, Emory University and the University of Buffalo.
The number of infants receiving mixed feeding was too small (table 1) to estimate precisely its effect
on diarrhoeal disease, and for further analysis they were combined either with exclusive breast milk or with formula.
Population attributable fractions (PAFs) for
diarrhoeal disease associated with infant feeding variables were estimated as (proportion of cases exposed) × (OR − 1) / OR.13 Survival analysis was used to estimate the prevalence of breast feeding at age 6 months while allowing for censoring, due to some infants being aged under 6 months.
Conclusions: Breast feeding protects against
diarrhoeal disease in infants in England although the degree of protection may vary across infants and wear off after breast feeding cessation.
Cases and controls, or their guardians, were asked to complete a postal risk factor questionnaire, which included variables on infant feeding, social factors, accommodation, travel, and contact with persons
with diarrhoeal disease.
However, the odds
of diarrhoeal disease increased with the time since breast feeding cessation (pT = 0.002 for linear trend in all infants).
These three interventions could potentially ameliorate at least 20 % of annual global deaths from treatable disease (unfortunately we haven't yet figured out cardiovascular disease): Lower respiratory infection (list item # 3);
Diarrhoeal disease (list item # 1); HIV / AIDS (list item # 2).
Breastfeeding and hence relactation are important for two reasons: Infant health: research shows that breastfed babies are less likely to suffer from acute respiratory infections,
diarrhoeal diseases, and malnutrition.
Now, thanks to health workers at all levels; the major international agencies - including WHO, UNICEF and USAID; ministries of health: non-government organisations; and Dialogue on Diarrhoea, control of
diarrhoeal diseases is an essential child health programme in virtually every developing country.
During; the current cholera epidemic in Latin America, remarkably, less than 1 per cent of those affected have died, thanks to a decade or more of control of
diarrhoeal disease (CDD) training and preparation.
It is therefore extremely important that nurses have solid pre-service training in
diarrhoeal diseases.
Management of
diarrhoeal disease in the newborn requires accurate diagnosis and quick responses from health personnel and mothers, with emphasis on preventing dehydration by increasing fluid intake and on ensuring adequate calorie intake through suitable feeding.
Our results suggest that the cumulative effect of breast feeding, as measured using duration, is less important for
diarrhoeal disease than the time since breast feeding cessation.
For infants who had been weaned, information was not collected on the types of food they were weaned onto, but data were available on consumption of foods in the 10 days prior to symptoms in cases (interview in controls), but none were significantly associated with
diarrhoeal disease (data not shown).
In the community cohort component of the main
diarrhoeal disease study, the incidence rate for this definition of diarrhoeal disease was 3.5 and 3.2 per 100 person - years in infant boys and girls respectively.
Unadjusted matched odds ratios for
diarrhoeal disease and selected risk factors in all infants
The present study formed part of
a diarrhoeal disease study conducted in 70 general practices in England.10, 11 The practices were volunteers from the UK Medical Research Council's general practice research framework, and were nationally representative with respect to geographical location, urban and rural characteristics, and Jarman social deprivation index.
Potential confounding factors associated with
diarrhoeal disease (p < 0.10) were included in a multivariate model where infant feeding was the main exposure.