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Last update: Mar 2013

Diarrhoea

Progress


Since 2004, UNICEF and the World Health Organization (WHO) have recommended treating childhood diarrhoea by replacing fluids through oral rehydration therapy (ORT), using oral rehydration salts (ORS), the ‘gold standard’ for ORT. If ORS packets are not available, recommended home-made fluids (RHF) or increased fluids are also recommended. Fluid replacement should be accompanied by continued feeding. Zinc supplementation, which decreases the severity and duration of a diarrhoea episode, is another recommendation. These interventions have proved cost-effective, affordable and relatively straightforward to implement. However, globally only 39 per cent of children under five with diarrhoea are given the recommended treatment (ORT and continued feeding).

 

In sub-Saharan Africa and South Asia the regions with the most diarrhoea deaths – there is very low coverage with this treatment package (35 and 38 per cent respectively).

 

Only about 4 in 10 children with diarrhoea are given the recommended treatment
Proportion of children aged 0–59 months with diarrhoea receiving oral rehydration therapy (ORS or recommended homemade fluids or increased fluids) and continued feeding, countries with available data, 2007–2012

 

                                                         

* Excludes China.
Note: Estimates are based on a subset of 86 countries with available data for 2007–2012, covering 62 per cent of global under-five population (excluding China, for which comparable data are not available) and at least 50 per cent of the under-five population in each region. Data coverage was insufficient to calculate the regional average for Latin America and the Caribbean.
Source: UNICEF global databases 2012, based on Multiple Indicator Cluster Surveys, Demographic and Health Surveys and other national surveys.

 

Oral rehydration salts (ORS)

A solution made from oral rehydration salts (ORS) is the ‘gold standard’ to treat childhood diarrhoea. Although this intervention has been proven effective, the data indicate that still just one third of children with diarrhoea in developing countries receive ORS solutions during their illness. There has been little progress since 2000 (data not shown).

 

Only about one in three children with diarrhoea are given ORS
Percentage of children under five with diarrhoea who receive ORS, 2007–2012

 

                                                                 

* Excludes China.
Note: Estimates are based on a subset of 69 countries with available data for 2007–2012, covering 67 per cent of the global under-five population (excluding China, for which comparable data are not available) and at least 50 per cent of the under-five population in each region. Data coverage was insufficient to calculate the regional average for CEE/CIS, Latin America and the Caribbean, and Middle East and North Africa.
Source: UNICEF global databases 2012, based on Multiple Indicator Cluster Surveys, Demographic and Health Surveys and other national surveys.

 

Urban rural gap - Across all regions, children in urban areas are more likely to receive treatment with ORS solutions, a gold standard to prevent dehydration, when they are sick with diarrhea, as compared to children in rural areas.

 

Diarrhoea treatment with oral rehydration salts
Percentage of children under five with diarrhoea who receive ORS, by residence 2007–2012

 

                                  

*Excludes China.
Note: Estimates are based on a subset of 69 countries with available data for 2007–2012, covering 67 per cent of the global under-five population (excluding China, for which comparable data are not available) and at least 50 per cent of the under-five population in each region. Data coverage was insufficient to calculate the regional average for CEE/CIS, Latin America and the Caribbean, and Middle East and North Africa.
Source: UNICEF global databases 2012, based on Multiple Indicator Cluster Surveys, Demographic and Health Surveys and other national surveys.

 

Wealth divide - In the poorest countries the poorest children–those often at greatest risk of diarrhoea– are much less likely to receive ORS to treat diarrhoea than are the richest children.

 

The poorest children often do not receive solutions made of ORS to treat diarrhoea
Percentage of children under age 5 with diarrhoea receiving ORS (ORS packet or prepackaged ORS fluids), low-income countries, by household wealth quintile, 2006–2011 (per cent)

 

                                 

Note: Subnational estimates are often bracketed by large confidence intervals, so results should be interpreted with caution. The low-income group is based on the World Bank July 2011 classification (see http://data.worldbank.org/about/country-classifications/).
Source: UNICEF global databases 2012, based on Multiple Indicator Cluster Surveys, Demographic and Health Surveys and other national surveys. 

 

References

UNICEF, Global databases, 2012.

 

UNICEF, Pneumonia and Diarrhoea: Tackling the deadliest diseases for the world’s poorest children, New York, 2012.

 

UNICEF and World Health Organization, Diarrhoea: Why children are still dying and what can be done, New York, 2009.   
 

WHO/UNICEF Joint Statement, Clinical management of acute diarrhoea, 2004.