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Diarrhoea-a neglected cause of child mortality

Ami Banerjee
Last edited 17th March 2010

This week, the Lancet released two articles in its “Online First” section, both concerned with the second leading global cause of infant death: diarrhoea. A staggering one in every five child deaths—around 1•5 million a year —is due to diarrhoea, which kills more children than AIDS, malaria, and measles combined. I have previously blogged about the Zimbabwean cholera crisis and the tragedy of the long-established, but poorly translated treatments for diarrhoea. The first article draws attention to a new UNICEF report: “Diarrhoea: why children are still dying and what can be done”, and suggests a seven-point plan for diarrhoea control:


  1. Rotavirus and measles vaccinations
  2. Promotion of early and exclusive breastfeeding and vitamin A supplementation
  3. Promotion of handwashing with soap
  4. Improve water quantity and quality, including treatment and safe storage of household water
  5. Promotion of community-wide sanitation


  1. Fluid replacement to prevent dehydration
  2. Zinc supplements
    The authors find that only 39% of children with diarrhoea in developing countries are receiving these simple, cheap interventions.

The other, more hopeful Lancet article concerns a trial of a new cholera vaccine in more than 65 000 individuals, including children older than 1 year, living in an urban slum in India. Clusters of households were either allocated two doses of the vaccine or the placebo. At 2 years, the vaccine did not have any more side effects than the placebo and was 67% effective in protecting against cholera in the entire population. The vaccine was 49% protective against cholera in children aged 1—5 years, although its effectiveness dropped if the vaccine was not given in two doses. This vaccine is both effective and affordable, giving it great potential for mass immunisation programmes in cholera-endemic areas.

Record number of infants immunised but not in poor nations

Seems to be a glut of info this week on vaccines this week

with the BMJ publishing on the WHO report Record number of infants immunised but 24 million in poor nations not being reached, says report

Global immunisation levels of infants are now at their highest ever, a record 106 million in 2008, averting an estimated 2.5 million child deaths a year. However, vaccines still do not reach millions of children in poor developing nations, says a report by the World Health Organization,
Unicef, and the World Bank.

see: http://bit.ly/2f0Zqs

Seems there is a lot of value in doing simple vaccinations

The organisms causing bacteraemia in African children with sickle-cell anaemia are the same as those in developed countries. Introduction of conjugate vaccines against S pneumoniae and H influenzae into the childhood immunisation schedules of African countries could substantially affect survival of children with sickle-cell anaemia.

Bacteraemia in Kenyan children with sickle-cell anaemia: a retrospective cohort and case—control study
The Lancet, Volume 374, Issue 9698, Pages 1364 - 1370, 17 October 2009


So sad...

So sad that BASIC shortcoming kill millions of children: lack of food is another preventable cause that does not even require a health care system!

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