ZUL-HAJJ 14 1430 A.H.
TUESDAY DECEMBER 1 2009.
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Need to control diarrhoea at home
By Olayinka Olawale
Yemi Alala, a middle aged man in the medical field, died within 24 hours of showing symptoms of diarrhoea. He had gone to toilet four times between 10 p.m. and 5 a.m. but wasn’t alarmed by this.
Alala also didn’t take any medication because he thought it was not a serious problem. When he drove himself to a hospital at 6.30 a.m. – about eight hours after the frequent defecating began – the doctor said he came too late.
Mrs Jumai Alimi also had a similar experience. When her seven-month-old baby suddenly began excreting watery faeces, the seriousness of the situation didn’t occur to her.
Alimi said she had no knowledge of diarrhoea and learnt the hard way as her first child died of the disease.
``I did not see the situation as something very serious until after three days when my baby had become very weak and thin. I gave her some antibiotics.
``By the fourth day when I took her to the hospital, the doctor told me that my baby had lost all the zinc and nutrients in her body; he asked me to start praying for the child as only a miracle could save her life.
“It was indeed too late; I lost my first child”, she said with tears running down her cheeks.
But, in her case, Mrs Monsurat Banire, a food seller, knew that her two-year- old son had a condition she suspected was pile. She, therefore, sought traditional medical assistance.
``In retrospect, I can say I was an ignoramus. Even when the child was vomiting the herbal preparation I was administering, I still didn’t see the looming calamity.
“My handsome boy died soon after I took him to a nearby health center. I don’t think I’ll ever forgive myself for being such a fool”, she lamented amid tears.
Prof. Muyiwa Owolabi, the Nigeria Coordinator of an NGO, Zincfant, said “diarrhoea kills by dehydration”.
Owolabi disclosed this at a two-day training workshop on “Community Based Management of Moderate Malnutrition and Zincfant Supplementation for Household Level Management of Childhood Diarrhoea” recently in Lagos.
The training was organised by the Lagos State Ministry of Health in collaboration with the United Nations Children Fund (UNICEF) for nutrition officers in all the local government areas of the state.
Owolabi noted that many people, irrespective of age, die of diarrhoea because “it is either they don’t know its severity or how to confront the disease at its early stages.
``Diarrhoea is the frequent passing out of watery stool three or more times in 24 hours, which result to the loss of zinc and nutrients in the body.
``Diarrhoea is caused by infection of the gastrointestinal tract by virus, bacteria, parasite and fungi. These infections usually spread via contaminated water, food and can be aggravated by poor personal hygiene.
``The body loses water and electrolytes in the liquid stool. Fluids may also be lost through accompanying vomiting. There may be increased fluid loss in sweat and there is fever.
``There are three types of diarrhoea namely Acute Watery Diarrhoea, Persistent Diarrhoea and Bloody (Dysentery) Diarrhoea,`` he said.
He said that the symptoms include stooling, fever, dehydration and lack of appetite, adding “if it is not treated on time, it kills faster than imagined”.
He said that there are three types of dehydration that include mild, moderate and severe.
Owolabi explained that the easiest way to treat the disease is with Oral Dehydration Solution (ORS) or Salt and Sugar Solution (SSS) and Zincfant.
He said that the first step to take in such situation was to try and replace all the zinc and nutrient lost in the process of stooling with ORS or SSS.
``Salt and sugar solution can be prepared at the home level with five cubes of sugar and one level teaspoon of salt in 70cl of water. The solution should be taken within 24 hours of preparation”.
According to Owolabi, there are four ways of managing diarrhoea at home.
They are: prevention of dehydration by giving ORS to the victim, especially a child; giving food continuously; giving zinc supplementation for 14 days -- even when the stooling has stopped and knowing when to seek expert help.
He advised that diarrhoea should not be treated with antibiotics as was being widely practiced by many, including medical personnel.
``Diarrhoea is caused by a virus. Antibiotics can only be used in the case of bloody diarrhoea”.
He said that diarrhoea could be treated easily with Zincfant supplementation – a supplement donated free to Nigeria by UNICEF.
According to Owolabi, zinc is a component of many enzymes in the body; it is important for the growth and development of a child and is. However, most of the food in Nigeria does not give enough zinc.
The coordinator said that there is zinc deficiency in Nigeria. “Zinc can be found in animal food, meat and shell fish.
“Whole grains and legumes -- that are widely available -- contain zinc but is absorbed less because of high fiber”.
He said: ``Zincfant must be used with ORS to re-dehydrate a child with diarrhoea. Zinc reduces the duration of the disease, reduce severity as well as prevent reoccurrence of diarrhoea for, at lease, three months.
``One tablet of zinc, equivalent to 20 mg. will be given daily for 14 days. Research has shown that if a child uses it for between 10 and14 days, the child will be okay.
``If diarrhoea is treated immediately and adequately, infant mortality will be drastically reduced”.
Owolabi urged parents and caregivers to visit health centres in their locality to collect Zincfant free.
Available medical literature on Zinc says if it is given to a child – in his meals or as supplement -- his height, weight, bone development and sexual maturation would improve significantly.
It says that a child who is zinc deficient will have retarded growth, low brain capacity, behavioural problems, memory impairment, etc.
Mrs Oluwatoyin Adams, Assistant Chief Nutrition officer, Lagos state Ministry of Health, advised that parents should know the basic things to do when their children have diarrhoea.
Adams said that the training was to enlighten key personnel on the inclusion of zinc in the home and primary health care management of childhood diarrhoea.
``Everybody should know how to prepare the salt and sugar solution in emergency cases to re-dehydrate children suffering from diarrhoea,`` she said.
At the end of the workshop, participants noted that it was heartwarming that awareness campaigns on the danger of diarrhea and how to handle it – similar to first aid – was ongoing all over Nigeria.
“This is expected to reduce the high rate of infant mortality as diarrhea is among the six notable childhood killer diseases in Nigeria,” their communiqué added. (NANFeatures
