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Diarrhoeal diseases and Malnutrition in India

Diarrhoeal diseases affect millions of people in India annually killing people. Acute diarrhoeal disease and food poisoning accounts for third of laboratory confirmed disease outbreaks in 2017 including dengue, encephalitis, cholera and chikungunya among others according to Integrated Disease Surveillance Programme. The IDSP data is miniscule of the India’s population where 51.4% people go to private hospitals and 3.4 % get treatment at home. According to the data from the Global Burden of Disease, unsafe drinking water, excreta contaminated food, open defecation, unusable toilets, sewerage waste and not using soap for hand washing made diarrhoea the third biggest cause of premature deaths across ages in India in 2016 after heart and lung diseases. It accounts for 10% of the 962830 deaths of children under five years old in India. The diarrhoeal disease cause chronic malnutrition and lower immunity leading to frequent infections. It makes a child more vulnerable to infections and higher chances of fatality as most malnourishment –related deaths occur in children between 9 months and three years old. Acute malnutrition is more common as about 38% children are stunted and 35% are underweight as per National Family Health Survey -4 (2015-16). Poverty and social exclusion are the major factors for the lack of information among the people especially mothers. While bacteria are the most common fecal contaminants, viruses, protozoa and parasitic worms in the stools of infected people infect through soil, water and food. The absence of safe water, toilets and sewerage treatment facilities adds to the contamination. Studies have shown that simple measures like hand washing with soap and water prevents transmission of bacteria that causes diarrhoea while using oral rehydration can prevent hospitalization. The study presented by International Journal of Environmental Research and Public Health pointed out that hand washing with only water reduced bacteria to 23% while plain soap and water lowered it to 8%. The community including anganwadi workers and schoolteachers must be involved. Setting up of Nutritional Rehabilitation Centers to treat SAM children and providing nutritious midday meals to school children, strong monitoring of hygiene practices and toilets at both anganwadi centers and schools can be some of the measures to combat the diarrhoeal diseases.