Part 1 - The global magnitude of diarrhoeal disease in young children

Abstract

This chapter discusses the global magnitude of diarrheal disease in young children. The term diarrhea-malnutrition complex is often used to emphasize the importance of this association, and as the form that the malnutrition takes is almost invariably the marasmic form of protein-energy malnutrition, the term diarrhea-marasmus complex is also used. This analysis comprised 22 reports consisting of longitudinal, prospective, community-based studies of stable populations with low migration rates. In addition, to compare mortality data for large populations, two multicountry studies, in which death certificates provided a basis of cause of death, were also included. The review revealed that the specific definitions of diarrhea were described in only 10 of the 22 studies. In these 10 studies, eight different definitions were used and two studies used the mother's definition and eight studies used seven different combinations of stool frequency and appearance. Estimated median diarrheal mortality rates were based on 12 studies with active surveillance in developing countries in Asia and Latin America. Results throughout all the studies reviewed did not vary significantly according to region, definition of diarrhea or other noted factors.