CHAPTER 7: EPIDEMIOLOGICAL STUDY ON DIARROHEA

IN CARE MEDICAL CENTRE,JANAKPURDHAM

INTRODUCTION
Diarrhoea is the passage of 3 or more loose or liquid stools per day, or
more frequently than is normal for the individual. It is usually a symptom
of gastrointestinal infection, which can be caused by a variety of
bacterial, viral and parasitic organisms. Infection is spread through
contaminated food or drinking-water, or from person to person as a
result of poor hygiene.

PROBLEM STATEMENT
 When the WHO initiated diarroheal disease control
programme in 1980,approximately 4.6 million children
used to die each year of the dehydration caused by
diarrohea
 It is still a major killer of children under the age of 5
years,although its toll has dropped by a third over the
past decade from 1.2 million deaths in 2000 to 0.7 million
in 2011
 It now causes about 11% of child deaths worldwide
 90% of these deaths occur in sub Saharan Africa and
south asia
 The current estimation in under 5 children suggest that
there are about 1.4 billion episodes of diarrohea per year
with 123 million clinical visits annually and 9 million
hospitalization worldwide

IN NEPAL
 Progressively a major public health problem in Nepal resulting in
17,000 to 45,000 child death annually.
  According to the latest WHO data published in may 2014,diarroheal
diseases deaths in Nepal reached 6160 or 3.89% of total deaths
 The age adjusted death rate is 28.82 per 100000 population ranks Nepal
47th in the world

EPIDEMIOLOGICAL TRIAD

AGENT
-
VIRAL(ROTAVIRUS,ADENOVIRUS,NORW
ALKVIRUS,ENTEROVIRUS,CMV,CORONA
VIRUS)
- BACTERIAL(CAMPYLOBACTER
JEJUNU,E.COLI,SHIGELLA,SALMONELLA,
ACILLUS CERUS,VIBRIO
CHOLERA,STAPHYLOCOCCUS
AUREUS,CLOSTRIDIUM PERFRINGENS )
- OTHERS(E.HOSTOLYTICA,GIARDIA
INTESTINALIS,TRICHURIASIS,CRYPTOSPO
RIDIUM SPP,CYCLOSPORA)

HOST ENVIRONMENT
AGE-CHILDREN 6 MONTHS TO 2 YEARS
TEMPERATE CLIMATE(BACTERIAL
GENDER-MALE=FEMALE DIARROHEA)

MALNUTRITION,POVERTY,IMMUNODEFICIE WINTER(ROTAVIRAL DIARROHEA)

NCY,PERSONAL AND DOMESTIC
HYGIENE,INCORRECT FEEDING SHELTER,ALTITUDE,HUMIDITY,SANITA
PRACTISE,CURRENT OR RECENT MEASLES. TION,FOOD SUPPLY,WATER SUPPLY.

RATIONALE
 In a developing country like Nepal,due to poverty and illetracy along
with poor feeding habit ,it is one of the leading cause in mortality
and morbidity
 Highly neglected disease(generally not considered as disease)
 Negligence and mixed beliefs(major contributing factor for U5
morbidity and mortality)
 OBJECTIVE
GENERAL OBJECTIVES
 TO conduct an epidemiological study on diarrohea in care medical
centre,janakpur

Specific objectives
 To find out and analyse the time trend(yearly and monthly) of
diarrohea
 To define the person wise(age,sex) distribution of diarrohea

Methodology
• Study area: Hetauda Hospital, Makwanpur district 


• Study Design: Cross-sectional study 


• Study method: Quantitative method 


• Technique of information collection: Secondary data review