Global Progress in Implementing Revised WHO/UNICEF Recommendations for Clinical Management of Acute Childhood Diarrhoea

Abstract

Presenter: Dr. Olivier Fontaine; Child and Adolescent Health; WHO, Geneva; Switzerland

More than 1.5 million children under five continue to die each year as a result of acute diarrhoea. The number can be dramatically reduced through critical therapies such as prevention and treatment of dehydration with ORS and fluids available in the home, breastfeeding, continued feeding, selective use of antibiotics and zinc supplementation for 10–14 days.

These new recommendations, formulated by UNICEF and WHO in collaboration with the United States Agency for International Development (USAID) and experts worldwide, take into account new research findings while building on past recommendations.

Success in reducing death and illness due to diarrhoea depends on acceptance of the scientific basis and benefits of these therapies by governments and the medical community. It also depends on reinforcing family knowledge of prevention and treatment of diarrhoea, and providing information and support to underserved families.

In order to assist policy makers and programme managers in scaling up zinc supplementation as part of the clinical management of diarrhoea, new guidelines are being developed:

Introduction of zinc supplementation in Diarrhoea Diseases Control Activities - guidelines for policy makers and programme managers
Diarrhoea Treatment Guidelines for clinic-based healthcare workers
Diarrhoea Treatment Guidelines for community-based healthcare workers

In addition, efforts are being made to increase the availability of zinc supplements through

Application to include zinc in the WHO model list of Essential Medicine,

Developing specifications for the production of zinc tablets and zinc syrups,
Working with UNICEF on the procurement of zinc tablets, and
Facilitating the transfer of technology for the production of zinc dispersible tablets to developing countries pharmaceutical companies.

Finally, delivery mechanisms as well as the feasibility of incorporating zinc in the routine treatment of diarrhea are being investigated in different health systems.

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