While over half of the world’s population is at risk of diarrhea and more than 2.2 million persons are said to be dying from the disease annually, especially among children in developing countries, according to the World Health Organisation (WHO), not many low and middle income countries consider it a health emergency that must be tackled head on.
For instance, in Asia and Africa, it is regarded as one of the most deadly diseases affecting children, as the highest burden from the scourge globally is found in these two continents.
Over half of the deaths occur in just five countries: India, Nigeria, Afghanistan, Pakistan and Ethiopia. Today, Nigeria is the worst hit in Africa with over 150,000 deaths occurring yearly in the country, especially among children under age five. This is as United States Agency for International Development (USAID) has put the prevalence rate of the disease in Nigeria at 18.8 per cent, accounting for over 16 per cent of child deaths in the country.
The WHO says the highly deadly disease is mainly caused by poor sanitation, poor hygiene practices and intake of unclean water or infected foods.
Despite Nigeria’s various interventions to tackle the menace and reduce the prevalence of the disease in the country, it seems to be a hard nut to crack as outbreaks are still experienced in some parts of the country. Sometime last year, diarrhea outbreak hit over 22 Internally Displaced Persons’ camps in Maiduguri, capital of Borno State, with about 500 persons affected, resulting in frequent diarrhea and vomiting of the affected displaced persons.
Few months ago, there was reported case of about 300 students of Federal Government Girls College (FGGC) located in Efon-Alaaye, Ekiti State, who were hit by the outbreak of the disease, resulting in hospitalisation of most of the affected students.
Meanwhile, as some teachers from the school believed the water source might be the root of the diarrhea, others believed it may be due to contaminated food which the children might have taken.
The recently reported cases of two students of a popular secondary school in Lagos, who died of diarrhea last week; therefore bringing to the fore again the need for the government and stakeholders to find a lasting solution to what the WHO said ordinarily was preventable.
While the Minister of Health, Prof. Isaac Adewole, has ordered investigation into the deaths of the students, observers are still putting their ears to the ground to know the direct causal factors of the students’ deaths. They hoped the investigation by the Ministry of Health will reveal what went wrong.
According to experts, diarrhea is a condition of having more than three or more frequent, loose, or watery stool per day.
It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin with loss of the normal stretchiness of the skin and changes in personality.
In an interview with THISDAY, the Medical Director, Healing Hands Hospital, Ikorodu, Dr. Alfred Ikenna, said diarrhea was 100 per cent preventable through proper hygiene, including proper preparation of food, good hand washing culture; especially when preparing food and after the use of the toilet, as well as good culture of food storage.
“However, in cases where there are outbreaks of the disease, with a lot of people affected, there is a likelihood that their source of water has been contaminated or their source of food contaminated.
“One of the most common causes of infectious diarrhea is lack of clean water. Often, improper fecal disposal leads to contamination of groundwater. This can lead to widespread infection among a population, especially in the absence of water filtration or purification. Human faeces contain a variety of potentially harmful human pathogens.
“Water contaminated with human faeces for example from municipal sewage, septic tanks and latrines is of special concern. Animal faeces also contain microorganisms that can cause diarrhea. Diarrhea can also spread from person to person, aggravated by poor personal hygiene,” he added.
He called on people who still involve in open defecation to shun the health hazard, adding that the faeces of an infected person can most likely travel into water which other people use, including streams, lakes, rivers, among others.
“We also understand a lot of places in the country have no clean water, either for drinking or for cooking. The government should do something about this, because the citizens are entitled to it. Most of these things shouldn’t be left in the hands of the people because majority cannot afford it,” he noted.
He explained that since the disease thrives in places where water sources were compromised, government should work hard to ensure that all Nigerians have access to potable water. He believed potable water was a necessity for every citizen, hence the government must ensure that its citizens, whether in urban or rural areas have access to clean and potable water.
According to him, it was no longer news that the outbreak occur every year in the country, hence the need for sustained public education on its prevention. “Government should ensure that they do everything within their powers to provide potable water. As well as educate the people on the need to be cautious of the type of water they drink, as well as the nature of the raw and uncooked food they eat, as infected foods can be source of diarrhea.
“Fruits and vegetables should be properly washed before consumption. The outbreak of the disease also calls for increased personal hygiene and public health consciousness,” he noted.
Explaining the symptoms associated with diarrhea, Ikenna stressed that the disease was a medical emergency which must be tackled immediately it was noted because of the severity of symptoms it presents.
The symptoms, he said include increased frequency of bowel movements, watery stools, urgency to stool (having to use the toilet immediately), incontinence (leakage of stools), bloating, wind rectal pain, lower abdominal pain or cramping Nausea, vomiting, fever, blood or flecks of mucus in the stool, loss of appetite, weight loss, among others.
He explained that diarrhea due to infection may last a few days, or several weeks, as in persistent diarrhea. With severe cases being life threatening due to fluid loss in watery diarrhea, particularly in infants and young children, the malnourished and people with impaired immunity.
He advised that persons who experience these symptoms, should seek medical assistance from doctors or the hospital, to ascertain whether they have diarrhea or not, so that they can be attended to accordingly.
“Diarrhea can be prevented from spreading from one person to the other if personal hygiene is put into consideration. If someone in your home has diarrhea, take precautions to stop it from spreading: Disinfect the toilet, handle and the seat after the person has used it each time. Don’t share towels, cutlery or utensils with the person who is unwell,” he noted
As part of efforts to reduce this disease in the country, the Pharmaceutical Society of Nigeria, last year rolled out a programme to tackle issues of diarrhea and pneumonia, adding that the programme will tackle treatment of the diseases, as well as three other areas of healthcare.
The programme, according to the society will advocate for the use of Zinc/Oral Rehydration Solution (Zn/ORS) for childhood diarrhea, as this would drastically reduce the deaths occasioned by the disease.
