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Ovid: Oxford Handbook of Tropical Medicine

Editors: Eddleston, Michael; Pierini, Stephen; Wilkinson, Robert; Davidson, Robert Title: Oxford Handbook of Tropical Medicine, 2nd Edition Copyright ©2005 Oxford University Press (Copyright 2005 by M. Eddleston, S. Pierini, R. Wilkinson, and R. Davidson) > Table of Contents > Chapter 2 > Chapter 2D – Diarrhoeal diseases > Prevention of diarrhoea Prevention of diarrhoea Proper treatment of diarrhoeal diseases is highly effective in preventing death, but has no impact on the incidence of such diseases. It is every medical professional’s responsibility to teach family members and motivate them to adopt preventive measures. Do not overload the mother with technical advice, but emphasize the most important points for each particular mother and child.

  • Measures that interrupt the transmission of pathogen The various infectious agents that cause diarrhoea are virtually all transmitted by the faeco-oral route. Measures taken to interrupt the transmission of the causative agents should focus on the following pathways:
    • Giving only breast milk for the first 6 months of life.
    • Avoiding the use of infant feeding bottles.
    • Improving practices relating to the preparation and storage of weaning foods (to minimize microbial contamination).
    • Using only clean water for drinking.
    • Washing hands after defecation, disposing of faeces, and before preparing food.
    • Disposing of all faeces in a safe manner.
  • Measures that strengthen host defences A number of risk factors for frequent or severe diarrhoea reflect impaired host defences. Measures may be taken to improve this:
    • Continuing to breastfeed for the first 2 years of life.
    • Improving a child’s nutritional status by giving more nutritious food, including foods of animal origin that contain essential minerals such as zinc and other micronutrients. Giving complementary foods more often, from 3 times per day when first introduced at 6 months to 5 times per day at 12 months.
    • Immunizing against measles.
  • How doctors can help to prevent diarrhoea
    • Ensure appropriate in-service training of health facility staff.
    • Make sure that all staff are giving consistent messages on diarrhoea prevention and infant feeding.
    • Display promotional material on how to treat and prevent diarrhoea.
    • Be a good role model (breastfeeding, handwashing, water hygiene, latrine hygiene).
    • Take part in community-based activities to promote health.
    • Co-ordinate efforts for disease prevention with those of relevant government programmes.

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