Researchers Urge Wider Use of Diarrheal Disease Control Measures

Researchers from the Johns Hopkins Bloomberg School of Public Health urge wider use of oral rehydration solution (ORS), zinc supplementation and rotavirus vaccine to reduce the deaths from diarrheal disease worldwide. Diarrheal disease kills approximately 1.5 million children under age 5 each year. The researchers' findings and recommendations are published in the July 3 edition of The Lancet.

"New methods for prevention, management and treatment of diarrhea--including an improved oral rehydration formulation, zinc supplementation and rotavirus vaccines-- make now the time to revitalize efforts to reduce diarrhea mortality worldwide," writes Mathuram Santosham, lead author of the review and professor in the Bloomberg School's Department of International Health.

ORS was developed in the 1970s as an efficient and cost-effective way to replace the body's vital fluids lost to illness. Before oral rehydration, treatment for patients with diarrheal disease required hospital care and intravenous fluid replacement, which were unavailable and impractical in many developing countries where diarrheal disease is a major concern.

Although deaths from diarrheal disease dropped 75 percent from 1980 to 2008, diarrheal disease remains a leading cause of death for children under age 5. According to the authors, new interventions for treatment of diarrheal disease, such as an improved low osmolarity ORS, zinc supplementation and rotavirus vaccines for prevention of diarrhea provide an opportunity to revitalize diarrhea-control programs around the world. They urge international agencies, donor communities and developing countries to renew emphasis on prevention of diarrheal disease deaths.

"Unfortunately, diarrhea treatment in many countries is not a priority. Therefore, we cannot assume that diarrhea treatment will improve simply through introduction of zinc and low osmolarity oral solutions to these health systems," the authors write. "National governments and donors should recognize the urgent need for new resources to strengthen health systems for delivery of oral rehydration solution and zinc while maintaining an adequate supply chain and training health workers."

Additional authors of "Progress and barriers for the control of diarrheal disease" include Aruna Chandran, Sean Fitzwater, Christa Fischer-Walker, Abdullah Baqui and Robert Black of the Department of International Health at the Johns Hopkins Bloomberg School of Public Health, and Olivier Fontaine from the World Health Organization's Department of Child and Adolescent Health Development.