DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20192822

An assessment of factors responsible for diarrhoea deaths of under five children in rural and urban settings of India

Om Prakash Singh, Jatinder Bir Singh, Dushyant Mishra, Abhik Dutta

Abstract


Background: Very little scientifically based information is available on cause-specific mortality rates of diarrhoea among all regions and populations wherein an inequitable proportion exits in low-income households, which have fewer resources and less knowledge to manage burden than high-income households. The strategic purpose of the study is to identify gaps in care seeking in order to make changes in approach to address these gaps either directly by working with the community and by doing area specific advocacy to improve service delivery through government channels.

Methods: The study was conducted in nine locations (6 rural and 3 urban) of India. The ethical and confidentiality parameters of conducting verbal autopsies were followed and random sampling methodology was adapted.

Results: Respondents of our study attributed 22% deaths to diarrhoea. From the study, it is revealed that children who passed stool for 5 or more number of times in a day are more likely to die 1.5 times than the children who passed stool for 3 times a day. Children having diarrhoea for 5 days or more than 5 days are more likely to die 1.6 times in comparison to the children who have had diarrhoea for 3 days. Approximately seven of the ten children died within five days of treatment.

Conclusions: Information on diarrheal diseases, its determinants in India and preventive and control strategies in light of recent developments need to be reviewed for better planning and organization of health services within the community.


Keywords


Diarrhoea management, Verbal autopsies, Treatment of diarrhoea, Rural urban diarrhoea cases, Prevalence of diarrhoea

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References


Amouzou A, Velez L, Tarekegn H, Young M. One is too many: Ending child deaths from pneumonia and diarrhoea. New York: UNICEF; 2016.

Ministry of Health and Family Welfare, Government of India. Intensified Diarrhoea Control Fortnight: Operation Guidelines, 2017. Available at: http://www.nhm.gov.in/nrhm-components/rmnch-a/child-health-immunization/2018-01-09-07-16-32/idcf-2018.html. Accessed on 12 January 2019.

Mills A. Health care systems in low- and middle-income countries. N Engl Med. 2014;370:552-7.

Park K. Epidemiology of communicable disease. Textbook of Preventive and Social Medicine. 19th ed. Jabalpur, India: Banarsidas Bhanot; 2007: 142–147.

Gupta P, Murali MV, Seth A. Epidemiology of diarrhea in urban slums. Indian Pediatr. 1998;35(2):147–51.

Walia BNS, Singhi S, Gambhir SK, Sora SR. Impact of acute diarrhoea and ORS on nutritional status of preschool children. Indian J Med Res. 1989;90:415–25.

Das R, Nath P, Khan Z. Correlates of diarrhoea in under five. Indian J PSM. 2001;1(2):61–9.

Bern C. Diarrhoeal diseases. In: Christopher JL, Murray AD, Lopez CD, eds. Global Epidemiology of Infectious Diseases. Geneva: WHO; 2004: 1–27.

Negi K. Demographic profile of children affected with diarrhoea in a rural community of Varanasi. 34th Annual Conference of IPHA 1995.

Lal P, Joshi PL, Bhattacharya M. The magnitude of diarrhoea in children in urban slums of Allahabad. Indian J PSM. 1993;24(4):148–52.

Troeger C, Blacker BF, Khalil IA, Rao PC, Cao S, Stanaway JD, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2018;18(11):1211-28.

Jayalakshmy R, Roy G, Premarajan KC. Incidence and risk factors of acute diarrheal disease among under-five children in urban slums in Pondicherry-One year follow-up study. Indian J Matern Child Health. 2011;13:1–11.

Black RE, Allen LH, Bhutta ZA, Caulfield LE, Onis M, Ezzati M, et al. Maternal and child under nutrition: global and regional exposures and health consequences. The Lancet –The Maternal and Child Undernutrition Series. 2008;371(9608):243-60.

Bhutta ZA, Das JK, Walker N, Rizvi A, Campbell H, Rudan I, et al. Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost? The Lancet – Childhood Pneumonia and Diarrhoea Series. 2013;381(9875):1417-29.

Munos MK, Walker CL, Black RE. The effect of oral rehydration solution and recommended home fluids on diarrhoea mortality. Int J Epidemiol. 2010;39(Suppl1):i75-i87.

Walker CL, Black RE. Zinc for the treatment of diarrhoea: effect on diarrhoea morbidity, mortality and incidence of future episodes. Int J Epidemiol. 2010;39 (Suppl 1):i63-i69.