Abstract
Despite improvements in global public health, diarrhoea causes more than 1.65 million deaths in 2016 which placed diarrhoea as the eighth leading cause of mortality in all ages and placed the fifth leading cause of death in children age five years and below in Malaysia. The impact of frequent diarrhoeal episodes is tremendous especially to children which include stunting and cognitive delay. There are three types of diarrhoea depending on the symptoms which are acute watery diarrhoea, acute bloody diarrhoea (dysentery) and persistent diarrhoea. Diarrhoea is commonly caused by Rotavirus, Cryptosporidium, Shigella, and Enterotoxigenic Escherichia coli (ETEC). Infectious agents for diarrhoea differ by transmission route, however, the risk factors of diarrhoeal episode are widely ranged and interconnected with each other which need to be identified. Modifiable risk factors such as the surrounding environment must be identified and improved which in turn avoid diarrhoea episodes. In this review, we identify the latrine and sanitation, waste disposal, housing condition, existence of animals, water quality, personal hygiene, seasonality and food hygiene/safety as environmental risk factors of diarrhoea.
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