15 February, 2010
After pneumonia, diarrhoea is the biggest killer of children below five years in India. A large number of these deaths can be prevented as dehydration is the main cause of diarrhoeal deaths. But, as most doctors do not prescribe the life saving combination of oral rehydration solution (ORS) and zinc, often children die because of diarrhoea.
This fact came to fore at a day long workshop organised by the Indian Academy of Paediatrics (IAP), central unit here on Sunday. The workshop, supported by Unicef, was part of IAP’s plan of action to check the number of preventable diarrhoea deaths, thereby bringing down country’s infant mortality rate. It may be noted that Uttar Pradesh accounts for 25% of total infant deaths in India.
“Most children suffer with acute diarrhoea. The condition can be easily managed by simple administration of ORS along with zinc and proper feeding. But a large number of medicos follow prescription practices which are of little help as far as dehydration (the chief cause of diarrhoeal deaths) is concerned,” said Dr Archana Kumar, a paediatrician with Chhatrapati Shahuji Maharaj Medical University and president, IAP, Lucknow unit.
Secretary, Lucknow unit of IAP, Dr S Niranjan informed that prescription practice refers to the tendency wherein doctors prescribe unnecessary medicines to manage a clinical situation. He said the specific case of diarrhoea antibiotics are needed only in four conditions: blood in stool, cholera, malnourishment and systemic infection.
Various studies show that zinc enhances a patient’s immunity while causing recovery of the cells in the gut. Experts point out that the combination of ORS and zinc, if supported by proper feeding, can save a child’s life.
It is normally seen that some parents stop giving food to children in case of diarrhoea. But, this worsens the condition. Experts recommend that mothers should continue to breastfeed if the child is an infant. Simple food like pulses, rice, dalia, khichidi may be given to older children so that they do not become weak.
State unit office–bearers of IAP, Dr Ajay Kalra, Dr Vineet Saxena and Dr Ashok Rai were also present on the occasion. State coordinator Dr Ashok Rai informed that the workshop saw representation from many important cities.
The persons trained here will hold similar workshops in their districts to sensitise doctors on the issue.
- More than 1.58 children below five years die of diarrhoea every year.
- Any child born in India suffers from diarrhoea at least once before the age of five years.
- Dehydration is the main cause of diarrhoeal deaths.
- Dehydration can be easily prevented by administering ORS solution to children.
- Experts say there is no need of antibiotics, pro–biotics, anti–motility and anti–secretory drugs.
- Blood in stool, cholera, malnourished child and systemic infection are the only conditions which require antibiotics for control.