Prevention of spread of diarrhoea|ICDS Supervisor|ICDS Supervisor Exam Kerala PSC
In this post, the Prevention of the spread of diarrhoea is explained ie, in the previous post we discussed ORS and ORT. Oral Rehydration Salt and Oral Rehydration Therapy. In the previous posts, we already discussed the types of dehydration in Diarrhoea is explained. Diarrhoea, one of the Infections spread by food and water is explained in another post. The Types of Diarrhoea and the pathogens of Diarrhoea are explained in detail. Other Infections spread by water are Typhoid, Paratyphoid fever, Poliomyelitis, Hepatitis A and Hepatitis E. Those will be explained in the coming posts. Immunization and Vaccines are important topics for ICDS Supervisor Exam.
Prevention of spread of diarrhoea
This is dependent upon:
• prevention of diarrhoea; and
• interruption of transmission of pathogens.
Although a wide variety of infectious agents cause diarrhoea, they are all transmitted through common pathways such as contaminated water, food, and hands.
Measures to interrupt the transmission should focus on the following pathways:
• giving only breast milk for the first 6 months of life;
• avoiding the use of infant feeding bottles;
• improving practices related to the preparation and storage of weaning fluids and feeds;
• washing hands after defecation or handling faeces, and before preparing food or eating;
• minimizing microbial contamination and growth of foods by preventing breaks in the food hygiene chain including
- use of human excrement as fertilizer;
- sale of foods in open-air markets where flies are numerous and food is uncovered;
- improper personal hygiene of food handlers;
- improper storage of previously cooked foods.
• using clean water for drinking;
• avoiding bathing in contaminated water with sewerage; and
• safely disposing of faeces, including infant faeces.
Measures that strengthen host defences A number of risk factors for frequent or severe diarrhoea directly relate to impaired host defences.
Measures that can be taken to improve host defences and thus diminish the risk of diarrhoea include:
• immunizing against measles;
• continuing to breastfeed for at least the first year of life; and
• improving nutritional status by improving the nutritional value of weaning foods and giving children more food.
Nursing care
Nursing care of the patient with infective diarrhoea requires:
• assessment and continuous observation of the clinical state;
• supervision and administration of appropriate fluid and food;
• maintenance of a fluid input and output chart;
• maintenance of a stool chart;
• monitoring of temperature, pulse and blood pressure;
• monitoring of weight, daily if the patient is a child;
• encouraging a scrupulous personal hygiene regime; and
• skincare to prevent excoriation.
Prevention of spread within the hospital depends upon:
• isolation of the patient and implementation of transmission-based precautions;
• scrupulous handwashing before and after attending to each patient;
• disinfection of soiled articles from infected patients;
• disposal of faeces: where the community has a modern well maintained sewage system, faeces can be disposed of into the sewage system without prior disinfection, but if the sewage system is inadequate, disinfection of faeces from infected patients should be undertaken individually.
• terminal cleaning of isolation rooms following the discharge of each patient; and
• controlling access of visitors to the isolation room Rehabilitation
Although temporary secondary lactose intolerance may delay recovery in any group of patients, those patients who respond to therapy and who had no preceding underlying disease should make a full recovery.
Rehabilitation may be more protracted in individuals with serious underlying disorders.
Giving a nutritious diet, appropriate for the child’s age, when the child is well is important.
Role of primary healthcare team
The primary healthcare team plays the following crucial roles in health education:
• Detection and acute assessment of diarrhoeal cases and supervision of their treatment in the community
• Identification of severe and complicated cases requiring referral to hospital
• Alerting of public health authorities to possible outbreaks of diarrhoeal disease
Role of the hospital
The hospital must undertake the secondary care management of cases, especially those cases where the patient is severely ill and/or severely dehydrated.
In addition, the hospital must determine the infecting organism and report it to the relevant public health authority; this is of primary importance in epidemic situations.
Role of the community
The community is responsible for ensuring the maintenance of good standards of food and water hygiene, educating about careful handwashing and other aspects of personal hygiene, and home
Health education/health promotion
Health education involves educating the community about:
• the risk to health from diarrhoea;
• ways in which enteric infections are transmitted;
• how infective diarrhoea can be prevented;
• treatment of diarrhoea, especially the role of oral rehydration solutions; and
• the importance of handwashing, safe disposal of excreta, and food and water hygiene.
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