Current and future management of childhood diarrhoea

Diarrhoea continues to have a devastating impact in infants and children. I t is a major cause of retarded growth. Substantial declines in hospitalizat ion rates and possibly in the mortality due to diarrhoea have occurred foll owing the launch of programmes based on oral rehydration therapy, and yet a bout 1 million diarrhoea-related deaths occur each year in South-East Asia. The World Health Organization currently recommends oral rehydration therap y plus continued breast- and complementary feeding for children with diarrh oea, and antibiotics for dysentery or associated systemic infection. Althou gh oral rehydration therapy has achieved substantial acceptance, physicians and families continue to prescribe and seek drug therapy to reduce diarrho eal duration and severity. Research is aimed at developing improved oral re hydration salt solutions or identifying adjunct therapy that will provide s ubstantial benefit in reducing stool output together with safety and select ivity of action. It must, however, be recognized that control of malnutriti on is a key requirement to reduce the duration and severity of acute diarrh oea. (C) 2000 Published by Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.